Otolaryngology Telemedicine Research Articles

Telemedicine in Otolaryngology in the Context of the End of the COVID-19 Public Health Emergency.

At the onset of the COVID-19 pandemic, the US Department of Health and Human Services implemented a range of flexibilities to expedite the adoption of telehealth. As our specialty moved past the height of the pandemic and the use of telehealth transitioned from a necessity to a convenience, numerous health care providers (physicians, advanced practice providers, speech-language pathologists, and audiologists) recognized its benefits and continued to offer these services. In May 2023, the current administration terminated the COVID-19 public health emergency declaration, with some telehealth guidelines in effect until December 31, 2023, and others extended through December 31, 2024. Amidst the changing telehealth landscape, the objective of this commentary is to explain policy implications on Otolaryngology-Head and Neck Surgery and provide insight into how to best implement telehealth under these new guidelines.

Patient and Visit Characteristics Associated With Otolaryngology Telemedicine Care.

Clinicians are increasingly adopting telemedicine in an effort to expand patient access and efficiently deliver care. The degree of health disparities among patients receiving otolaryngologic telemedical care is unclear. We performed a retrospective cross-sectional study to explore disparities in telemedicine delivery. We evaluated otolaryngology clinical visits from January 2019 to November 2022. We obtained patient demographics and visit characteristics (e.g., subspecialty, telemedicine vs in-person). Our primary outcome was demographic characteristics of otolaryngology patients who received telemedicine vs in-person care during the study timeframe. A total of 231,384 otolaryngology clinical visits were reviewed, of which 26,895 (11.6%) were telemedicine visits. Rhinology (36.5%) and facial plastics (28.4%) subspecialties performed the most telemedicine visits. On multivariate analysis, individuals who identified as Asian, non-English speaking, and with Medicare insurance were statistically significantly less likely to use telemedicine than in-person services. Our findings suggest that expanding telemedicine care may not improve access for all populations, and socioeconomic factors are important considerations to ensure patients are receiving equally accessible care. Futures studies are warranted to understand how these disparities may impact health outcomes and patient satisfaction with care.

COVID-19 and the resurgence of telehealth in otolaryngology

The objective of this review is to examine the impact of the ongoing Coronavirus disease 2019 (COVID-19) pandemic on the use of telehealth in Otolaryngology. The use of telemedicine rose dramatically during the pandemic to meet the need for continued patient care while allowing for physical separation of providers and patients. Telemedicine has been used to evaluate patients with a variety of pathologies including dysphonia, vertigo, and anosmia. Innovative use of at-home exams, such as video-otoscopy has aided providers in overcoming challenges associated with a highly specialized physical exam. The use of telemedicine in Otolaryngology will likely remain essential in the post-pandemic era and has promising results for improving clinical efficiency.

Patient and physician satisfaction with telemedicine in pediatric otolaryngology

Objectives1) Evaluate the caregiver-perceived benefits and barriers of a tertiary pediatric otolaryngology telemedicine service using the validated Telemedicine Satisfaction Questionnaire (TSQ); 2) Explore the provider's perception and experience on the current telemedicine platform using a modified Physician Satisfaction Questionnaire (PSQ). MethodsCaregivers of patients ≤18 years of age who received telemedicine services from May 4 to June 18, 2020 (duration of telemedicine use) were eligible for this study. Caregivers were contacted via telephone and given the option to answer the TSQ over the phone, receive a link via email, or decline participation. Providers were administered the modified PSQ as an anonymous, self-report online instrument on the 2 nd week of telemedicine implementation. The study authors were excluded from the PSQ. Results58/148 caregivers completed the TSQ. The TSQ questions were grouped into three categories: quality of care, similarity to in-person care, and perception of the interaction. Caregivers felt the most satisfied with the perception of the interaction (mean response 4.84, SD 0.08, p < 0.05). With the PSQ, providers had less favorable responses when compared to the TSQ across all categories (p < 0.05 for all categories) but did report satisfaction for the perception of the interaction (mean response 3.37, SD 0.85). ConclusionOur study demonstrates further evidence that the telemedicine may provide positive benefits. Caregivers were supportive of this service due to its convenience. Providers felt confident using this service, but they also felt the care provided was different from that in the clinic. Improvement in the telemedicine platforms and associated technology for physical exams may help improve the quality of telemedicine care, and similarity to in-person care.

Telemedicine in Otolaryngology During COVID-19: An Exploratory Assessment of Provider and Patient Attitudes.

To determine provider and patient attitudes toward telemedicine in Otolaryngology-Head and Neck Surgery (OHNS). Otolaryngology practitioners conducting outpatient clinics at an academic tertiary referral center were provided with a pre-Study Provider Perception Questionnaire (pre-PPQ) designed to evaluate pre-study perception of telemedicine in otolaryngology. A post-study Provider Perception Questionnaire (post-PPQ) designed to evaluate elements similar to those constituting the PrePPQ was completed at 6 weeks. Additionally, following each visit, providers and patients completed Individual Encounter Survey Questionnaires (IESQ) to evaluate the virtual clinical encounter experience. The pre-PPQ was completed by 29 providers, while the post-PPQ was completed by 12 providers. A total of 236 post-visit provider IESQs were completed, of which 208 were deemed successful. Audio/visual (AV) difficulties and limited server connectivity for the patient were most common causes for unsuccessful encounters. Providers reported that the most appropriate use of telemedicine, on both pre-PPQ and post-PPQ, was triaging patients to determine the need for in-person visits. The inability to perform a physical exam was rated as the primary barrier to telemedicine in OHNS on both pre-PPQ and post-PPQ. Patients strongly agreed with the statements, "My healthcare provider was able to understand my healthcare condition" and, "I felt comfortable communicating with my healthcare provider" 92.0% and 95.4% of the time, respectively. Both providers and patients demonstrated an overall positive attitude toward the use of telemedicine in the provision of otolaryngologic care.

Telemedicine and Telementoring in Rhinology, Otology, and Laryngology: A Scoping Review.

ObjectiveTelemedicine and telementoring have had a significant boost across all medical and surgical specialties over the last decade and especially during the COVID-19 pandemic. The aim of this scoping review is to synthesize the current use of telemedicine and telementoring in otorhinolaryngology and head and neck surgery.Data SourcesPubMed and Cochrane Library.Review MethodsA scoping review search was conducted, which identified 469 articles. Following full-text screening by 2 researchers, 173 articles were eligible for inclusion and further categorized via relevant subdomains.ConclusionsVirtual encounters and telementoring are the 2 main applications of telemedicine in otolaryngology. These applications can be classified into 7 subdomains. Different ear, nose, and throat subspecialties utilized certain telemedicine applications more than others; for example, almost all articles on patient engagement tools are rhinology based. Overall, telemedicine is feasible, showing similar concordance when compared with traditional methods; it is also cost-effective, with high patient and provider satisfaction.Implications for PracticeTelemedicine in otorhinolaryngology has been widely employed during the COVID-19 pandemic and has a huge potential, especially with regard to its distributing quality care to rural areas. However, it is important to note that with current exponential use, it is equally crucial to ensure security and privacy and integrate HIPAA-compliant systems (Health Insurance Portability and Accountability Act) in the big data era. It is expected that many more applications developed during the pandemic are here to stay and will be refined in years to come.

Telemedicine in Otolaryngology During COVID‐19: Patient and Physician Satisfaction

To examine patient and physician satisfaction with telemedicine in otolaryngology during COVID-19 and identify associated factors. Prospective cohort study. Tertiary care center. Patient satisfaction was rated by patients (age ≥18 years) who had encounters from May to July 2020 (n = 407). Physician satisfaction was rated by 15 otolaryngologists for specific encounters delivered from May to June 2020 (n = 1011). Patient satisfaction was measured with a Press Ganey questionnaire and a Telemedicine Satisfaction Questionnaire. Mean Press Ganey satisfaction scores of telemedicine encounters during COVID-19 were compared with the pre-COVID-19 Press Ganey scores from in-person encounters (n = 3059) to test a noninferiority hypothesis. Physician satisfaction was measured with a Provider Satisfaction Questionnaire. The mean Press Ganey patient satisfaction score for telemedicine encounters was 94.5 (SD, 8.8), no worse than that for in-person encounters prior to COVID-19 at 93.7 (SD, 15.5; Δ = 0.8 [95% CI, -0.5 to 2.1, excluding the noninferiority margin of -1]). Encounters with videoconference (vs telephone) and patients reporting higher income were associated with higher Telemedicine Satisfaction Questionnaire scores. Physician satisfaction scores during COVID-19 with telemedicine encounters were overall high at 83.3 (95% CI, 77.5-89.1), slightly lower when compared with the scores with in-person encounters at 88.4 (95% CI, 82.5-94.3; Δ = -5.2 [95% CI, -6.6 to -3.8]). Encounters with videoconference (vs telephone) and patients with English as a preferred language and follow-up visits were associated with higher Provider Satisfaction Questionnaire scores. Telemedicine is a feasible alternative format in otolaryngology during COVID-19 with overall high patient and physician satisfaction. Patient satisfaction with telemedicine encounters during COVID-19 was no worse than in-person encounters prior to the pandemic. Physician satisfaction with telemedicine was relatively lower in comparison with in-person encounters.

Eligibility for live, interactive otolaryngology telemedicine: 19-Month experience before and during the COVID-19 pandemic in Taiwan

BackgroundUnequal access to healthcare is a global medical problem. Telemedicine, recently made possible by technological advances, may mitigate this inequity. However, the usefulness of telemedicine for procedure-driven disciplines, such as otolaryngology, under infectious conditions (e.g., the COVID-19 pandemic) is unknown. MethodsTelemedicine was made legal in Taiwan by an amendment to the Physician Act in 2018. Kaohsiung Chang Gung Memorial Hospital was the first hospital in Taiwan to provide the telemedicine service by connecting to the Chenggong Branch of Taitung Hospital (CGBTH) in November 2018. This retrospective cohort study included all new and established otolaryngology outpatient consultations between November 2018 and May 2020 at CGBTH. The Current Procedural Terminology and International Classification of Disease, 10th Revision codes, patient demographic data, and questionnaire data were obtained. ResultsThe study included 123 patients with 218 encounters over 19 months. The majority of complaints were ear-related (52.6%). Overall, 49% of the encounters required a specialized procedure for diagnosis and treatment; of these, cerumen removal was the most common procedure. The patient subjective improvement rate increased over the study period (from 62.0% to 78.9%). The rates of return and case closure were both around 90% in 2018 and 2019. The number of otolaryngology consultations and rate of return declined after the start of the COVID-19 pandemic; however, the subjective improvement and case closure rates remained stable. The telemedicine service saved at least 2 h driving time per visit. ConclusionTelemedicine for otolaryngology is a promising approach for remote and underserved regions, as well as during an infectious disease pandemic.

Telemedicine in Otolaryngology During COVID-19 Pandemic: Our Experience

Telemedicine in Otolaryngology During COVID-19 Pandemic: Our Experience

Patient and Provider Satisfaction With Telemedicine in Otolaryngology

ObjectiveThe objective of this study is to evaluate patient and provider satisfaction with telemedicine encounters across 3 otolaryngology practices.Study DesignCross-sectional survey.SettingA military community hospital, an academic military hospital, and a nonmilitary academic center.MethodsA telephone-based survey of patients undergoing telemedicine encounters for routine otolaryngology appointments was performed between April and July 2020. Patients were asked about their satisfaction, the factors affecting care, and demographic information. A provider survey was emailed to staff otolaryngologists. The survey asked about satisfaction, concerns for reimbursement or liability, encounters best suited for telemedicine, and demographic information. The results were analyzed with descriptive statistics and a multivariable logistic linear regression model to determine odds ratios.ResultsA total of 325 patients were surveyed, demonstrating high satisfaction with telemedicine (average score, 4.49 of 5 [best possible answer]). Patients perceived “no negative impact” or “minor negative impact” on the encounter due to the lack of a physical examination or face-to-face interaction (1.86 and 1.95 of 5, respectively). High satisfaction was consistent across groups for distance to travel, age, and reason for referral. A total of 25 providers were surveyed, with an average satisfaction score of 3.44 of 5. Providers reported “slight” to “somewhat” concern about reimbursement (40%) and liability (32%).ConclusionGiven patients’ and providers’ levels of satisfaction, there is likely a role for telemedicine in otolaryngology practice that may benefit patient care independent of the COVID-19 pandemic.

Self-monitoring of the tympanic membrane: An opportunity for telemedicine during times of COVID-19 and beyond

The interest for telemedicine has increased since the COVID-19 pandemic because of the risk of infection. Recently, commercial companies started selling digital USB-otoscopes (DUO) that can be connected to a mobile phone. These DUOs are inexpensive (costing approximately $6–35 each) and make it possible to visualize the whole tympanic membrane. Here, we illustrate the case of a patient who had operative correction of a tympanic membrane retraction, and who self-monitored the tympanic membrane in the course of time. Additionally, we discuss the use of DUOs in otolaryngology telemedicine practice. The use of simple digital USB otoscopes provides a promising method to assess and monitor the tympanic membrane remotely. However, more research is needed to establish the role of DUOs in telemedicine.

Medical Student Participation in Otolaryngology Telemedicine Clinic During COVID-19: A Hidden Opportunity.

The undergraduate medical student educational experience was greatly altered this year due to coronavirus disease 2019. Many otolaryngology departments increased use of telemedicine technologies to avoid the need for in-person contact. Medical student incorporation into telemedicine clinics is important to increase their comfort with this format of patient care and to continue student exposure to the field of otolaryngology. The technical and logistical aspects of student inclusion in telemedicine clinics at our institution are detailed. While telemedicine is still an evolving tool for experienced practitioners, there are likely advantages to the use of telemedicine patient visits for student learning. These may include closer working relationships between student and preceptor, as well as increased opportunities for student observation and feedback. Medical students should not assume telemedicine experiences are of inferior educational quality to in-person patient interactions. Future research should investigate ways telemedicine could enhance student learning.

Feasibility of Asynchronous and Automated Telemedicine in Otolaryngology: Prospective Cross-Sectional Study.

BackgroundCOVID-19 often causes respiratory symptoms, making otolaryngology offices one of the most susceptible places for community transmission of the virus. Thus, telemedicine may benefit both patients and physicians.ObjectiveThis study aims to explore the feasibility of telemedicine for the diagnosis of all otologic disease types.MethodsA total of 177 patients were prospectively enrolled, and the patient’s clinical manifestations with otoendoscopic images were written in the electrical medical records. Asynchronous diagnoses were made for each patient to assess Top-1 and Top-2 accuracy, and we selected 20 cases to conduct a survey among four different otolaryngologists to assess the accuracy, interrater agreement, and diagnostic speed. We also constructed an experimental automated diagnosis system and assessed Top-1 accuracy and diagnostic speed.ResultsAsynchronous diagnosis showed Top-1 and Top-2 accuracies of 77.40% and 86.44%, respectively. In the selected 20 cases, the Top-2 accuracy of the four otolaryngologists was on average 91.25% (SD 7.50%), with an almost perfect agreement between them (Cohen kappa=0.91). The automated diagnostic model system showed 69.50% Top-1 accuracy. Otolaryngologists could diagnose an average of 1.55 (SD 0.48) patients per minute, while the machine learning model was capable of diagnosing on average 667.90 (SD 8.3) patients per minute.ConclusionsAsynchronous telemedicine in otology is feasible owing to the reasonable Top-2 accuracy when assessed by experienced otolaryngologists. Moreover, enhanced diagnostic speed while sustaining the accuracy shows the possibility of optimizing medical resources to provide expertise in areas short of physicians.

The impact of the coronavirus (COVID-19) pandemic on elective paediatric otolaryngology outpatient services – An analysis of virtual outpatient clinics in a tertiary referral centre using the modified paediatric otolaryngology telemedicine satisfaction survey (POTSS)

IntroductionVirtual outpatient clinics (VOPC) have been integrated into both paediatric and based adult outpatient services due to a multitude of factors, including increased demand for services, technological advances and rising morbidity secondary to ageing populations. The novel coronavirus disease (COVID-19) has accentuated pressures on the National Health Service (NHS) infrastructure, particularly elective services, whilst radically altering patterns of practice. AimTo evaluate the impact of the COVID-19 pandemic on paediatric otolaryngology outpatient services whilst collating patient feedback to elicit long-term sustainability post COVID-19. MethodA retrospective analysis of VOPCs was undertaken at a tertiary paediatric referral centre over a 3-month capture period during the COVID-19 pandemic. Demographic, generic clinic (presenting complaint, new vs. follow-up, consultation type), as well as outcome data (medical or surgical intervention, discharge vs. ongoing review, onward referral, investigations, and conversion to face-to-face) was collated. Additionally a modified 15-point patient satisfaction survey was created. The Paediatric Otolaryngology Telemedicine Satisfaction survey (POTSS), was an adaptation of 4 validated patient satisfaction tools including the General Medical Council (GMC) patient questionnaire, the telehealth satisfaction scale (TESS), the telehealth usability questionnaire (TUQ), and the telemedicine satisfaction and usefulness questionnaire (TSUQ). ResultsOf 514 patients reviewed virtually over a 3-month period, 225 (45%) were randomly selected to participate, of which 200 met our inclusion criteria. The most common mode of consultation was telephony (92.5%, n = 185). Non-attendance rates were reduced when compared to face-to-face clinics during an equivalent period prior to the COVID-19 pandemic. A significant proportion of patients (29% compared to 26% pre-VOPC) were discharged to primary care. Nine percent were listed for surgery compared to 19% pre-VOPC. A subsequent face-to-face appointment was required in 10% of participants. Overall, the satisfaction when assessing the doctor-patient relationship, privacy & trust, as well as consultation domains was high, with the overwhelming majority of parents’ content with the future integration and participation in VOPCs. ConclusionAn evolving worldwide pandemic has accelerated the need for healthcare services to reform in order to maintain a steady flow of patients within an elective outpatient setting without compromising patient care. Solutions must be sustainable long-term to account for future disruptions, whilst accounting for evolving patient demographics. Our novel survey has demonstrated the vast potential that the integration of VOPCs can offer paediatric otolaryngology services within a carefully selected cohort of patients.

Telemedicine in Otolaryngology in the COVID-19 Era: Initial Lessons Learned.

Objectives/HypothesisThe COVID‐19 pandemic has led to unprecedented global changes in the delivery of healthcare over a short period of time. With the implementation of shelter‐in‐place orders, otolaryngology clinic visits at our institution were transitioned to telemedicine. This change enabled the rapid characterization of the patients who accepted and declined telemedicine.Study DesignCross‐sectional analysis.MethodsA review was conducted of 525 otolaryngology patients at a tertiary‐care referral center with scheduled visits requiring rescheduling to a future date or a telemedicine visit. Visit, demographic information, and reason for deferring telemedicine were collected for analysis.ResultsSeventy‐two percent of patients declined a telemedicine visit, with the most common reason being the lack of a physical exam (97%). There was an even distribution of demographics between those who accepted and declined visits. There was an association between declining telemedicine with older age (P = .0004) and otology visits (P = .0003), whereas facial plastics patients were more likely to accept (P < .0001). Patients scheduled earlier during the pandemic were more likely to accept a visit with a median of 28 days from onset of shelter‐in‐place orders versus 35 for those who declined (P < .0001).ConclusionsWe describe our initial experience with a transition to telemedicine, where the majority of patients would decline a virtual visit due to the lack of a physical exam. Although the future remains uncertain, telemedicine will continue to play a vital role in healthcare delivery. We believe that understanding our patient base gives critical insights that will help guide and improve virtual care to meet patients' needs.Level of Evidence4 Laryngoscope, 130:2568–2573, 2020

Patient Perceptions of Head and Neck Ambulatory Telemedicine Visits: A Qualitative Study.

During the COVID-19 pandemic, there has been unprecedented use of telemedicine for otolaryngology ambulatory visits. Patient satisfaction with telemedicine is an important metric, but survey-based questionnaires do not capture the nuances of the patient experience. This study aims to understand head and neck patients' perceptions about telemedicine clinic visits during COVID-19. Fifty-six established patients who had video-based telemedicine visits with an otolaryngology-head and neck surgery faculty member between March 25, 2020, and April 24, 2020, completed unstructured telephone interviews. Conventional content analysis was used to analyze the interview data. Retrospective chart reviews were conducted to determine the patients' demographic, disease, and treatment information. The primary benefits of telemedicine were accessibility and cost and time savings. Primary limitations included the ability to perform a physical examination. Most patients expressed a willingness to participate in future remote visits if appropriate or necessitated by social circumstances. Telemedicine is a disruptive process, and long-term adoption requires understanding patient perception of and satisfaction with telemedicine. Head and neck cancer patients were generally satisfied with telemedicine. The study elucidated patient perceived benefits and limitations of telemedicine. Continued implementation of telemedicine in otolaryngology-head and neck ambulatory clinics will require consideration of contextual features surrounding the virtual delivery of care, with particular attention to visit appropriateness for telemedicine and social circumstances.

Telemedicine in Otolaryngology: A Systematic Review of Image Quality, Diagnostic Concordance, and Patient and Provider Satisfaction.

Telemedicine allows for the remote delivery of patient care and has been found to have a wide range of uses in otolaryngology. In order to achieve best practices in telemedicine, a platform must be effective and both patients and providers must be satisfied with the use of technology. As telemedicine becomes more widely used in otolaryngology clinics, particularly in the face of the current COVID-19 pandemic, it is important to assess its applicability in this field. The goal of this study was to evaluate existing literature on telemedicine and assess overall image quality, diagnostic concordance, and patient and provider satisfaction with telemedicine technologies. A systematic review was conducted on PubMed and MEDLINE according to the PRISMA 2009 guidelines for articles from 1982 to 2019 relating to telemedicine in otolaryngology. English language studies with primary or secondary endpoints pertaining to image quality, diagnostic concordance, or patient or provider satisfaction were included. Descriptive studies, editorials, and literature reviews were excluded. A total of 32 studies were included in our review. Studies assessing imaging quality and diagnostic concordance reported adequate results but with some heterogeneity. Patient and provider satisfaction were consistently high. The literature supports telemedicine delivery of otorhinolaryngologic care as having achieved high rates of patient and provider satisfaction with adequate image quality and heterogeneity in diagnostic concordance. Variability in diagnostic accuracy was reported, but appears improved given proper clinical context. More standardized studies are needed specific to telemedicine in the field of otolaryngology.

Screenshot Photography: Optimizing Photo-Documentation While Using Telehealth Video Platforms.

Facial Plastic Surgery & Aesthetic MedicineVol. 22, No. 4 ViewpointScreenshot Photography: Optimizing Photo-Documentation While Using Telehealth Video PlatformsJacob I. Tower, Jonathan Y. Lee, and Yan Ho LeeJacob I. Tower*Address correspondence to: Jacob I. Tower, MD, Division of Otolaryngology, Department of Surgery, Yale School of Medicine 47 College St., ENT Office, New Haven, CT 06510, USA, E-mail Address: jacob.tower@yale.eduDivision of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.Search for more papers by this author, Jonathan Y. LeeDivision of Plastic and Reconstructive Surgery, Department of Surgery, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts, USA.Search for more papers by this author, and Yan Ho LeeDivision of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.Search for more papers by this authorPublished Online:2 Jul 2020https://doi.org/10.1089/fpsam.2020.0225AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited byCOVID-19 and the resurgence of telehealth in otolaryngologyOperative Techniques in Otolaryngology-Head and Neck Surgery, Vol. 33, No. 2Telemedicine in cleft surgery: Overcoming geographical barriers and improving health outcomes19 February 2022Telemedicine in Cleft Surgery: Overcoming Geographical Barriers and Improving Health Outcomes21 July 2022The digital doctor: telemedicine in facial plastic surgery25 May 2021 | Current Opinion in Otolaryngology & Head & Neck Surgery, Vol. 29, No. 4Continuation of telemedicine in otolaryngology post-COVID-19: Applications by subspecialtyAmerican Journal of Otolaryngology, Vol. 42, No. 3Telemedicine Practices of Facial Plastic and Reconstructive Surgeons in the United States: The Effect of Novel Coronavirus-19 Parsa P. Salehi, Sina J. Torabi, Yan Ho Lee, and Babak Azizzadeh6 November 2020 | Facial Plastic Surgery & Aesthetic Medicine, Vol. 22, No. 6 Volume 22Issue 4Aug 2020 InformationCopyright 2020, American Academy of Facial Plastic and Reconstructive Surgery, Inc.To cite this article:Jacob I. Tower, Jonathan Y. Lee, and Yan Ho Lee.Screenshot Photography: Optimizing Photo-Documentation While Using Telehealth Video Platforms.Facial Plastic Surgery & Aesthetic Medicine.Aug 2020.240-242.http://doi.org/10.1089/fpsam.2020.0225Published in Volume: 22 Issue 4: July 2, 2020Online Ahead of Print:May 27, 2020PDF download

Telemedicina en la práctica del otorrinolaringólogo en el período de contingencia del COVID-19

IntroducciónLa pandemia por el nuevo Coronavirus nos ha afectado a todos y muchos hemos tenido que cerrar o disminuir sustancialmente nuestra práctica. Sin embargo, es necesario mantener comunicación con nuestros pacientes que continúan requiriendo de nuestra atención y manejo. Es aquí donde la telemedicina en otorrinolaringología juega un rol muy importante. MétodosSe realizó una revisión narrativa de la literatura mediante una búsqueda en PUB-MED y EMBASE a conveniencia con respecto a la información disponible sobre telesalud y telemedicina en el área de la Otorrinolaringología. Además se incluyó literatura de asociaciones de otorrinolaringología a nivel mundial y lineamientos y normas del gobierno colombiano&#x0D; Discusión La telemedicina es una útil herramienta para la atención de pacientes en esta contingencia. Debemos seguir ciertos parámetros, elegir adecuadamente a los pacientes y actuar con honestidad y buena fe. Se realizan sugerencias del beneficio de la telesalud y telemedicina, consideraciones especiales en nuestra práctica médica, alcances de los servicios mencionados e implementación de estos en nuestros consultorios e instituciones basados en la literatura disponible, normas legales y experiencia de los autores. Conclusión En la práctica del Otorrinolaringólogo es posible implementar la telemedicina con el aval de las aseguradoras y la aceptación de los pacientes. Se debe ser extremadamente cuidadoso con el diligenciamiento de la historia clínica, con la formulación de medicamentos y seleccionar adecuadamente a los pacientes. La telemedicina en otorrinolaringología es una herramienta valiosa que nos permite continuar atendiendo a pacientes seleccionados cuidándolos a ellos y a nosotros.

Cost savings associated with an outpatient otolaryngology telemedicine clinic.

ObjectiveTo test the null hypothesis that there is no difference in patient cost savings between the telemedicine and traditional face‐to‐face approach. The second objective was to assess the financial impact on the peripheral healthcare system, as compared with staffing a conventional clinic with “on‐site” otolaryngologist.MethodsTwenty‐one patients were enrolled. To assess “patient‐benefit” cost savings, a model was formulated that would utilize a certified nurse practitioner (CNP) to conduct a general otolaryngology clinic at the peripheral site, as compared with having to travel to the tertiary referral center. A “peripheral site‐benefit” cost analysis was performed to assess costs of initiating and operating a telemedicine clinic at the peripheral site, compared with having an on‐site otolaryngologist.ResultsThe total patient‐benefit cost savings would be $182.09 per patient per encounter and $333.22 per patient annually. The fixed cost to the peripheral site to initiate the telemedicine system was $9,895. Two hundred sixty telemedicine encounters would be needed to offset the initial cost, and 537 encounters would be needed to surpass revenue of the conventional clinic.ConclusionA real‐time telemedicine otolaryngology clinic provides significant cost savings for both patients and the peripheral healthcare system. This pilot study supports telemedicine as a cost‐effective approach to providing general otolaryngology care to rural patients.Level of Evidence4