Provide Telemedicine Services Research Articles

Assessment of the Use of Telemedicine by Brazilian Otolaryngologists through an Online Questionnaire

Abstract Introduction The coronavirus disease 2019 (COVID-19) pandemic has prompted a transformation in medical practice, including the adoption of telemedicine in Brazil and globally. Otorhinolaryngology, a field at high risk of viral transmission, has witnessed an increasing use of telemedicine tools. However, the extent and challenges of telemedicine in this field in Brazil are not well understood. In the present study, we applied a questionnaire to Brazilian otorhinolaryngologists during the pandemic to assess telemedicine's advantages and challenges, shedding light on its integration and persistent issues in the field. Objective To assess the usage profile of telemedicine in the clinical practice of otolaryngology in Brazil. Methods The present was a cross-sectional observational study with convenience sampling. It was conducted as a web-based questionnaire distributed and advertised to Brazilian otorhinolaryngologists through social media posts on WhatsApp (Meta Platforms, Inc., Menlo Park, CA, USA), Instagram (Meta Platforms, Inc.), Facebook (Meta Platforms, Inc.), as well as direct messaging and email. Results The sample size was 186 participants. A total of 69% of them had already provided or were currently providing telemedicine services, and 34% considered it a frequent or very frequent form of work at the time of data collection. In total, 90% of the respondents considered the lack of physical examination a problem in otolaryngological teleconsultations, while 64% reported frequently or very frequently resolving patient problems through teleconsultations. Conclusion Telemedicine emerged in the context of the COVID-19 pandemic as a promising tool for remote patient care. More studies are needed to elucidate its role in the context of limited physical examination.

The Provision and Perceptions of Telemedicine Services Among Traditional Chinese Medicine Practitioners During COVID-19: A Cross-Sectional Study in Hong Kong, China.

Objectives: Telemedicine has been widely used during the COVID-19 pandemic. Among other health care professionals, Chinese medicine practitioners (CMPs) face practical challenges in providing telemedicine consultations. This study aims to explore CMPs' experience and perceptions of telemedicine service provision before and during the pandemic. Methods: A territory-wide cross-sectional online survey was conducted in Hong Kong between April and May 2022. A structured questionnaire with open-ended questions was used to investigate the provision of and perception on telemedicine service, as well as usability of telemedicine among CMPs. Results: A total of 195 CMPs participated the survey. Before COVID-19, 42% (81/195) had been providing telemedicine services, and the proportion doubled during COVID-19. CMPs in the private sector are the main providers. Mobile apps including WhatsApp, WeChat, and Zoom were commonly used for consultations (75%, 120/161). Barriers in providing telemedicine included inability of conducting physical examination on patients (69%, 134/195), legal and ethical concerns over medical negligence (61%, 118/195), and patients' incompetence on e-literacy (50%, 98/195). Respondents urged professional and regulatory bodies to provide an explicit clinical guideline that demonstrate best practice in traditional Chinese medicine telemedicine, and to clarify legal and ethical implications of such practice. Conclusions: CMPs demonstrated their competency in telemedicine, and most of them provided telemedicine during COVID-19. Development of appropriate guidelines on the provision of telemedicine would support CMPs to continue provision after the pandemic, whereas a user-friendly and comprehensive telemedicine e-platform would enhance quality of such service. Facilitating patients with lower e-literacy to access telemedicine is key to reduce disparities.

Stability of telemedicine legislation: current issues

The main features and problems of the development of legislative regulation of telemedicine in the Russian Federation are considered. The stages of such development are identified and analyzed: the existence of a concept, the existence of detailed regulation, the establishment of the possibility of deregulation within the framework of a legal experiment, the beginning of a legal experiment. The correlations between changes in the telemedicine services market and changes in legislation and regulated public relations are considered. The probable reasons that prompted the legislative bodies to establish detailed regulation of relations in the field of telemedicine have been identified, given that the provision of telemedicine services has never been prohibited (encouraging participants in civil turnover to use this legal institution, public interest in regulated public relations). The aim of the work was to formulate the problems of non-systemic changes in legislation on telemedicine, their determinants and further optimal development vectors. The research methodology is based on historical and teleological methods that allow us to consider the problems of legal regulation of telemedicine, based on the peculiarities of the formation of legislation in this area. The paper analyzes statistical data, regulations and materials of judicial practice; using the comparative legal method, general and various trends with the development of other legislative institutions are identified. It is concluded that regular changes in legislation on telemedicine, undermining its stability and predictability of legal regulation, have their reasons for the lack of conditionality of reforms with the current concept of development of legislation on telemedicine, as well as the redundancy of the adopted regulatory regulation. Taking into account the absence of civil law litigation on the provision of telemedicine services, it is proposed to expand deregulation in this area beyond the legal experiment: extending its provisions to the current legislation as a whole. This need is indirectly confirmed by statistical data on a significant increase in the provision of telemedicine services after their legislative consolidation, with its subsequent decrease and the introduction of a legal experiment on deregulation after that. The study is financially supported by the Russian Science Foundation, project No. 23-78-10175, https://rscf.ru/project/23-78-10175/.

Insight into the Digital Health System of Ukraine (eHealth): Trends, Definitions, Standards, and Legislative Revisions.

This article aims to provide an in-depth examination of the digital health system of Ukraine, focusing on the emerging trends, precise definitions, established standards, and recent legislative revisions that shape the practice and implementation of eHealth solutions within the country. The digital health landscape in Ukraine has witnessed significant transformations, especially in the wake of the COVID-19 pandemic and subsequent military conflicts. These events have catalyzed the expansion of telemedicine services, leading to innovative approaches in healthcare delivery. The national strategy underscores the necessity for human-centric and accessible telemedicine, reinforced by technological neutrality, and harmonization with global standards. A review of the current literature, national strategies, and legal documents was conducted, alongside an analysis of data usage and service provision patterns in various Ukrainian regions. Participation in the "Science for Safety and Sustainable Development of Ukraine" competition facilitated project initiatives like the development of a cloud-based platform for patient-centered telerehabilitation for oncology patients. The utilization of telemedicine has significantly increased in conflict-affected regions, demonstrating the need for, and the effective deployment of, digital health strategies under crisis conditions. Private health facilities and entrepreneurs have been pivotal in the provision of telemedicine services. Legislative efforts have been geared toward framing telemedicine as an integral component of the national eHealth system, ensuring interoperability, and aligning with international standards and the Internet of Medical Things (IoMT). The findings underscore the resilience and adaptability of the Ukrainian healthcare system in the face of adversity. There is a clear trend towards a more integrated, patient-focused, and technologically advanced healthcare model, aligning with international trends and prioritizing public health goals over private profits. This progress, however, is contingent upon continuous development, investment in technological infrastructure, and legislative support to sustain and advance digital health initiatives.

Development of telemedicine in the Czech Republic from patients' and other key stakeholders' perspective.

Telemedicine is a way to improve healthcare outcomes with greater efficiency for both patients and care providers. The great potential of digital technologies also lies in strengthening the patient-centered approach. The early successes and benefits of telemedicine in the Czech Republic, amplified by the COVID-19, have contributed to the fact that wider implementation of telemedicine is already generally supported at the expert and public levels. Our research focuses on the identification of key issues in the implementation of telemedicine and the challenges of telemedicine in the future, from the perspective of patients and other stakeholders. The study is based on a qualitative research approach, combining focus groups with key stakeholders, patient panels and expert panels (2021-2022). The lack of rules and uncoordinated development of various activities proved to be the main barriers to the integration of telemedicine in the health system. This regulatory uncertainty can generate a number of problems in the patient-doctor relationship in practice, including ethical ones, and can also lead to inequalities in access to healthcare and affect the overall quality of care provided. Furthermore, it has been shown that patients' interests in the implementation of telemedicine are: 1. a predictable and reliable framework that guarantees them certainty and security in the provision of telemedicine services, 2. telemedicine solutions that increase the availability and efficiency of the care provided while bringing comfort, and 3. user-friendly and simple solutions. At the same time, patients want to understand the new environment and be active participants in the process of digital innovation, including the practical implementation of telemedicine. The research team has developed recommendations for further developments in the implementation of telemedicine that reflect the patient's interest and can be implemented at three levels - the health system, institutional, and community level. In countries with a well-developed and institutionalized patient movement, the community level can be represented by patient organizations, thus becoming the link between telemedicine policy making and implementation at the individual level of healthcare provision. For the further development of telemedicine, the development of a national strategy involving all key stakeholders, including patients, in the implementation has proven essential.

User perceptions of COVID-19 telemedicine testing services, disease risk, and pandemic preparedness: findings from a private clinic in Hong Kong.

During the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has been regarded as a method for providing safe access to healthcare. Here, we explored the experiences of individuals using telemedicine in Hong Kong during the COVID-19 pandemic to understand their risk perceptions and preparedness measures. We conducted a cross-sectional online survey of telemedicine users of private clinic-based COVID-19 testing services from 6 April to 11 May 2020. All users were invited to complete an anonymous online survey regarding COVID-19 risk perception and preparedness measures. The results of the survey were compared with the findings of a previous territory-wide survey. In total, 141 of 187 telemedicine users agreed to participate; the response rate was 75.4%. Of the participants, 95.1% (116/122) believed that telemedicine consultations were useful. Nearly half of the participants (49.0%) agreed or strongly agreed that telemedicine consultations were appropriate during the COVID-19 pandemic. Most participants believed that telemedicine consultations could perform the functions of 'health protection, promotion and disease prevention' (73.6%) and 'diagnosis' (64.0%). Concerning the choice of telemedicine provider, almost all participants (99.2%) were willing to consult medical doctors; more than half of the participants (54.1%) were willing to consult registered nurses, but only 13.1% were willing to consult non-clinical staff who had been trained to provide telemedicine services. The use of telemedicine for screening and patient education can be encouraged during the COVID-19 pandemic in Hong Kong.

Pharmacists' attitudes and intention to adopt telemedicine: Integrating the market-orientation paradigm and the UTAUT

The severe impact of the SARS-CoV-2 (COVID-19) virus on healthcare systems caused a sharp increase in patients' demand for telemedicine. Despite this acceleration, and while telemedicine is usually associated with the transition to a market-oriented paradigm in healthcare, available studies have not examined to what extent health professionals' attitudes and intention to adopt telemedicine are shaped by customers' demand. This study addressed this gap by proposing a model that combines the market-orientation paradigm with the unified theory of acceptance and use of technology (UTAUT) to explain pharmacists' attitudes toward telemedicine and its adoption. The findings from a survey of 202 pharmacists revealed that market orientation is positively associated with performance expectancy, effort expectancy, and social influence but negatively related to facilitating conditions. In turn, performance expectancy, effort expectancy and facilitating conditions affect the intention to adopt telemedicine. These findings have implications for the network of actors involved in the provision of telemedicine services.

Impact of Infectious Diseases Consultation in Patients With Candidemia at a Multisite Health Care System With Established Antimicrobial Stewardship and Telemedicine Services.

Infectious diseases consultation improves outcomes in patients with candidemia, although some facilities lack access to consultation. This multisite health care system study compared in-hospital mortality in patients with candidemia across 3 groups-those who received on-site consultation, telemedicine consultation, or no consultation. All patients were reviewed by an antimicrobial stewardship pharmacist. A retrospective observational cohort study was performed of adult hospitalized patients with candidemia from January 2018 to October 2021. The primary outcome was in-hospital mortality. Secondary outcomes included receipt and duration of antifungals, removal of central venous lines if present, ophthalmologic examination, echocardiography, and determination of infection source. A total of 265 patients were evaluated: 187 in the on-site consultation group, 49 in the telemedicine consultation group, and 29 in the nonconsultation group. Although in-hospital mortality did not differ significantly between the on-site and nonconsultation groups, it was significantly lower in the telemedicine group when compared with the nonconsultation group (10.2% vs 34.5%, P = .009). Patients who received on-site or telemedicine consultation had significantly more antifungal therapy initiated, appropriate therapy duration, central lines removed, and echocardiography performed, as well as fewer unknown candidemia sources, vs those in the nonconsultation group. This is the first study of a multisite health care system providing telemedicine services to evaluate the impact of infectious diseases consultation on candidemia mortality. These findings suggest that when on-site consultation is unavailable, infectious diseases telemedicine consultation and antimicrobial stewardship can improve outcomes and should be considered for all patients with candidemia at resource-limited sites.

Variations in Physician Telemedicine Provision

This cross-sectional study assesses variation in the provision of telemedicine services among primary care physicians and quantifies the extent to which this variation may be explained by the individual physician vs temporal, patient, or visit factors.

Requirements, Challenges, and Key Components to Improve Onboard Medical Care Using Maritime Telemedicine: Narrative Review.

Telemedicine has been able to bring healthcare services to all people in far locations such as the sea. Our main objective was to overview the main features, challenges, and requirements of applying telemedicine at sea. The electronic search includes all types of papers published in English. It was performed in four databases with keywords to Feb 2023. Next, main categories were defined to extract major concepts. By mapping extracted themes, maritime telemedicine concepts were represented in two conceptual models. After screening the papers based on title and abstract, 18 articles remained. They can be divided into 13 categories based on their clinical domains. Out of 18 reviewed articles, six articles were published in 2020. The greatest number of studies with five articles was conducted in France. Evidence showed that maritime telemedicine service can be provided to all kinds of ships. Regarding clinical domains, the greatest demand belonged to primary care problems (5 papers) and general health assessment (4 papers). Challenges were divided into four main categories. Moreover, the required services and equipment in four categories were described too. Finally, a conceptual model is represented for providing telemedicine services at sea using satellite Internet. Despite the existing challenges in providing the required equipment and resources for the implementation of maritime medicine, it has an important role in providing better care for seafarers without time limitations.

Assessing Medical Students' Comfort with Telemedicine.

The Association of American Medical Colleges (AAMC) has recommended that the provision of telemedicine services become an entrustable professional activity (EPA). Given its increased scope, medical student comfort with telemedicine was explored. An institutional review board-approved 17-question, anonymous voluntary survey was created based on the AAMC's EPAs and administered to students at Northeast Ohio Medical University across 4 weeks. The primary outcome of this study was to assess medical students' self-reported telemedicine comfort levels. The response rate was 141 students (22%). At least 80% of students believed that they were able to gather essential and accurate patient information, counsel patients and families, and communicate effectively across a broad range of social, economic, and cultural backgrounds using telemedicine. In total, 57% and 53% of students, respectively, believed that they were able to gather information and diagnose patients using telemedicine as well as they did in person, 38% of respondents believed that their patient's health outcome was the same via telemedicine or in-person visits, and 74% of respondents wished that telemedicine was formally taught in school. Most of the students believed they could effectively gather essential information and counsel patients via telemedicine, but there was a notable decrease in confidence for medical students when comparing telemedicine and in-person care directly. Despite the EPAs created by the AAMC, students did not self-report the same comfort level with telemedicine as they had with in-person patient visits. There are opportunities for improvement in the telemedicine medical school curriculum.

Providing telemedicine services to persons living with HIV in an urban community: a demonstration project

ABSTRACT Although HIV incidence and mortality rates have declined over the past 20 years, HIV health disparities continue to persist among patients living in urban communities. Barriers to proficient health outcomes for persons with HIV (PWH) in urban communities include lack of access to care, resulting from limited transportation or clinic availability. While healthcare systems in rural communities provide telemedicine (TM) services to PWH to eliminate transportation and accessibility barriers, few examples exist regarding TM use for PWH in urban communities. This project’s goal was to increase the provision of healthcare services in an urban setting to PWH, using TM. As guided by “Integration of Healthcare Delivery Service” theories and key principles, we created an integration framework comprised of several simultaneous, overlapping activities to include: (1) capacity building (2) clinical standardization (3) community and patient engagement and (4) evaluation performance and measurements. This paper describes major activities involved with developing, implementing and evaluating a TM program for PWH. We discuss results, challenges, and lessons learned from integrating this program into our existing healthcare system.

Public Use of Telemedicine Communication Technology and Its Relationship to Healthcare Quality: A Comparative Study between the Egyptian and Saudi Public

Objectives: The research aims to identify the public's use of communication technology for the provision of remote medical services and its relationship to the quality of healthcare.
 Methods: The two researchers used the field survey method and a comparative approach to identify similarities and differences in the study sample. The study was conducted with a sample of 400 individuals from the Egyptian public. The survey newspaper tool was employed, and various statistical techniques were utilized, including the Pearson correlation coefficient and the t-test.
 Results: The findings of the study indicate a statistically significant correlation between the public's use of communication technology for providing remote medical services and the quality of healthcare. Additionally, a statistically significant correlational relationship exists between the role of communication technology in providing telemedical services and the development of public usage, along with its contribution to generating interest in these services.
 Conclusions: It is crucial to emphasize the public's use of communication technology for providing telemedicine services in order to achieve the Sustainable Development Goals (SDGs) and the global commitment to attaining universal health coverage by 2030.

The Russian telemedicine market in the context of economic sanctions: Development prospects

Subject. This article discusses the problems of quality of medical services. Objectives. The article aims to determine the areas of development of the Russian telemedicine market in the context of economic sanctions. Methods. For the study, we used the logical and statistical analyses. Results. The article finds that despite the difficulties associated with the ban on the supply to Russia of technical devices necessary for the production of equipment, Russia has accumulated actual experience in providing telemedicine services, and a large number of large digital platforms have been created in the field of healthcare. Conclusions. To develop telemedicine tools and services in Russia, it is necessary to improve the methodological and regulatory framework, and intensify the processes of import substitution in the medical industry.

PS-C03-13: THE POTENTIAL AND EXPECTATIONS OF CONSUMER-DRIVEN MARKETING FOR TELEMEDICINE IN HYPERTENSION FINDINGS FROM A CONCEPT SURVEY AND DEPTH INTERVIEWS

We provide telemedicine services to manage hypertension, utilizing our consumer-driven marketing knowledge. We have established a system jointly with TelemedEASE, a general incorporated association, and launched the service “Hypertension e-medical” in 2021. We performed quantitative and qualitative surveys to analyze consumer psychology and examined the essence of the value provided by telemedicine services for hypertension. Survey Methods: Findings (1) Depth interviews The primary intention of new users of telemedicine was “convenience,” such as no need for visiting hospital and reduced waiting time, while the next largest potential value was “a sense of reassurance”. Many patients have concerns that they are unable to discuss with their doctors regarding hospital visits and medication. In some cases, patients felt that they didn’t receive sufficient explanations from their doctors after only a short consultation, and in other cases, even if they did receive explanations, their concerns were not fully resolved. The ability to monitor one's own symptoms by measuring one's blood pressure at home and the “a sense of reassurance” provided by medical staff watching over the smartphone Apps can be of great value to patients. (2) Concept survey Of all subjects including treated and untreated patients, 76.1% had blood pressure of 130/85 mmHg or higher, and 62.5% was on regular blood pressure medication. Majority (56.4%) regularly measured their home blood pressure. At the time of the survey, 56.4% knew about online visits but only 2.4% had used it. Currently, only 13.2% of the respondents were willing to use telemedicine. Patients in their 30 s and 40 s seemed to value “peace of mind”, as the intention to use the service was about 1.7 times higher when the focus concept was “peace of mind” compared to when it was “convenience” in this age group. Conclusion: In Japan, telemedicine from the first visit recently became permanently available. The number of users is expected to increase. Providing value based on an accurate understanding of such consumer insights is important. The findings may help lead to designing services to encourage the initiation and continuation of treatment in patients with hypertension.

JS-HOPE ASIA-4: TELEMEDICINE IN HYPERTENSION

The COVID19 pandemic resulted in lock-downs and reduction of social interactions to reduce the risks of disease transmission. Routine medical services were affected and telemedicine was rapidly adopted for the diagnosis, monitoring, and treatment of many chronic diseases including hypertension. We look at the considerations for the design and set-up of telemedicine for the management of hypertension. Many aspects need attention in order to ensure a safe, reliable, and effective program. Many regulatory agencies developed guidelines, advisories, regulations, and legislation to manage telemedicine. We examine some of these guidelines and their differences in South East Asian countries. Often, the professional clinical service standards in telemedicine are maintained by the state medical boards or councils. Additional training or certification and licensure is needed prior to providing telemedicine services. In-person visits are required when remote consultations cannot meet the professional clinical standards. Because telemedicine can traverse national boundaries, different regulators differ in their approach to the provision of telemedicine services to overseas patients. Nonetheless, the doctor must meet the same standard of care for overseas patients. Also, practice insurance will need to explicitly cover the practice of telemedicine especially for overseas patients. Besides the professional clinical standards, telemedicine differs by technology platforms, communication devices, software, and blood pressure monitoring devices. These varied devices and software require further evaluation of technical standards for safety, reliability, data privacy, storage, transmission, and licensure. Some of the guidelines also cover the need for quality improvements and technology upgrades. Regardless, there have been many studies of telemedicine in hypertension covering many aspects of care. Some can be simpler telemonitoring of blood pressure to highly sophisticated ones with devices linked to personal communicators (usually cellphone) with feedback to healthcare professionals (doctors, nurses, dietitians, pharmacists) and tagged to clinical interventions to improve the control of hypertension. Reviews of these studies show that hypertension telemedicine programs are effective but the evidence may be available in different practice settings and patient types, thus, complicating the design and recommendations. Therefore, it is important to review the type of practice and patients, determine which aspects are lacking to be targeted, and designing a good program. A good program will lead to better clinical outcomes, patient satisfaction, lower cost, reduced manpower for delivery of care, and convenience all round. Clinical practice guidelines and undergraduate and postgraduate medical training need to encompass telemedicine for the future.

Telemedicine: validation of a questionnaire to evaluate the experience of health professionalsTelemedicina: validação de um questionário para avaliar a experiência dos profissionais de saúde

This objective of this work is to develop and validate a questionnaire to evaluate health professionals' experience with telemedicine systems. Based on an abbreviated, locally validated Spanish-language version of the patient questionnaire developed by Parmanto et al., a group of experts developed a version to evaluate the experience of health professionals who provide telemedicine services. The psychometric behavior of the items was tested in an initial sample of 129 professionals, using exploratory factor analysis. The comprehensibility of the items was then assessed through cognitive interviews. Finally, in a new sample of 329 professionals, the construct validity of the questionnaire was evaluated by means of confirmatory factor analysis (CFA); its criteria of external validity were assessed by comparing the score with that of a summary question. A 12-item questionnaire was obtained, with a two-factor structure and acceptable adjustment indicators documented through CFA. Reliability, convergent validity, and discriminant validity were appropriate. The criteria of external validity showed optimal results. The instrument obtained has adequate psychometric properties and will contribute to the objective evaluation of the experience of health professionals who perform telemedicine.

Factors Associated with Telemedicine Services Provision for Sexually Transmitted Disease Diagnosis and Treatment Among Dermatologists: Evidence from China.

Background:Telemedicine has experienced rapid growth in China, with wide applications for chronic disease management.Objective:This study examined a unique survey dataset to identify the provision of telemedicine services by dermatologists, and to explore its association with physician characteristics, perception of diagnosis, and physicians' perceptions of the advantages and disadvantages of telemedicine.Materials and Methods:Responses to an anonymous voluntary questionnaire were collected from 238 dermatologists in Zhejiang Province, China, via a mixed mode of online and in-person data collection. Data were analyzed using Stata 16.0. Empirical analyses utilized descriptive statistics and multivariable logistical regression.Results:Among a total of 238 physicians, 34.9% provided telemedicine services. Results from the multivariable logistic regression indicated that, if physicians can use their spare time to help patients, seniority and their perception of the benefit of telemedicine are the two most important factors determining their likelihood of providing telemedicine services among the studied sample.Conclusion:Telemedicine holds great promise, but its practices need to be more efficient to save time and reduce the risk of misdiagnosis so that more physicians may participate.

Two-stage robust telemedicine assignment problem with uncertain service duration and no-show behaviours

The current pandemic of COVID-19 has caused significant strain on medical center resources, which are the main plac healthcare managers to make an effective assignment plan for the patients and telemedical doctors when providing telemedicine services. Motivated by this, we present the first comprehensive study of a two-stage robust telemedicine assignment problem when three different sources of uncertainty are incorporated, including uncertain service duration, no-show behaviours of both patients and telemedical doctors. From an algorithmic viewpoint, we propose an efficient nested column-and-constraint generation (C&CG) solution scheme that decomposes the model into an outer level problem and an inner level problem. Our results show that we can solve the problems of realistic sizes within a reasonable time (e.g., up to 100 patients, 10 telemedical doctors, and 200 scenarios within two hours). On the empirical side, we demonstrate how the hyper-parameters make a balance between cost management and the coverage level of the served patients in the presence of three different sources of uncertainty. Our comparison with a two-stage stochastic programming model implies that our model is not overly conservative and seems to provide a relatively cheaper modeling alternative that requires much less information support when hedging against three different sources of uncertainty under a worst-case situation.

A Single-Center Prospective Observational Study Evaluating Telemedicine for Kidney Transplant Patients in the Coronavirus Disease-19 Pandemic

Introduction: The coronavirus pandemic has restricted access to health-care services for kidney transplant patients because of concerns of COVID-19 infection. This single-center prospective study was done to assess the feasibility, acceptability, and effectiveness of telemedicine services for regular follow-up of kidney transplant patients as well as for triaging patients for admission. Methods: The study was undertaken during the lockdown period in India from March 23, 2020 to June 30, 2020. A formatted message seeking all relevant information was sent before teleconsultation. WhatsApp/email using smartphones and Electronic Medical Records system were used to provide telemedicine services. At the end of the e-consult, the patient was asked to rate his experience on a scale of 0–10. Results: A total of 296 consults for 122 patients were given. Of these, 239 (80.7%) consults (96 patients) were for domestic patients and 57 (19.3%) consults (26 patients) were for international patients. The mean age of the patients was 43 ± 15 years. The mean patient satisfaction score for e-consults was 9.5 ± 0.7. Four (3.3%) patients were seen for the first time after transplant via teleconsultation. Nine (7.4%) patients were advised admission and the rest were advised follow-up teleconsultation. Among those admitted, 6 (4.9%) were COVID positive and 1 (0.8%) patient died of COVID-19 pneumonia. Conclusions: Telemedicine offers a viable modality for health-care delivery when access to health care is restricted for transplant patients. Our model of telemedicine can be replicated easily without the burden of high cost for infrastructure.