Virtual Consultations Research Articles

Nurses' perceptions of virtual consultations and home-monitoring in patients with cardiac disease: a qualitative meta-synthesis

Abstract Objective This study aims to investigate the facilitators and barriers perceived by nurses in utilizing video-consultations supported by home-monitoring for patients with cardiac disease. Methodology A systematic search was conducted in PubMed, CINAHL, Scopus, and Web of Science for qualitative data published in English, Norwegian, Swedish, or Danish between 2013-2023. Ten studies were included in the qualitative synthesis using Braun and Clarke's methodology. Findings From the qualitative meta-synthesis, a main theme emerged: Nurses’ uncertainty toward telemedicine is a risk toward the use of video-consultations and home-monitoring The findings spans from nurses' positive encounters to their frustrations with the implementation process and the inadequate technical support for both clinicians and patients. Nurses frequently experienced frustration and uncertainty regarding the quality of care delivered through virtual consultations. Conclusion The successful implementation of video-consultations and home-monitoring necessitates a focus on the specific context in which they are applied, considering the perspectives of both patients and nurses. Additionally, active involvement of nurses, leveraging their clinical expertise, is crucial for the effective integration of these technologies.

A mixed-method review of the efficacy of a virtual fracture clinic: an 8-year follow up

Background: Virtual fracture clinics are well established methods of managing trauma patients safely and effectively. While they have been widely adopted, there is a lack of research on their longer-term implementation and success. Aims: This paper aimed to review factors that may influence the success of a virtual fracture clinic. Methods: Business analytics were used to calculate clinic discharge and return rates, as well as the reasons for them. Qualitative analysis was used to look at patient satisfaction with virtual consultations; data were extracted from two differing time points via telephone interviews. Results: The mean discharge rate across the 2014–2021 period was 28%. The largest discharge rate was seen in 2014 (43%) and the lowest was seen in 2021 (28%). Return rates to the emergency department at the two different time points were 2% and 0.9% respectively. Patient satisfaction was rated as ‘good’ or higher in all parameters at both time points. Discussion: This article describes the long-term success of a virtual fracture clinic. Results demonstrate excellent patient satisfaction coupled with the lowest return rates in the published literature. Discharge rates started extremely high and have declined with time. The factors for these results are discussed along with ideas for further prospective research.

Understanding adoption intention of virtual medical consultation systems: Perceptions of ChatGPT and satisfaction with doctors

This study examined the impact of perceptions of ChatGPT, the leading AI chatbot since November 2022, on the acceptance and perceived efficacy of future GPT-powered virtual medical consultation systems (GPT-VMCSs), as well as their influence on the propensity to adopt such systems amid debates over their suitability for medical consultations. By utilizing the technology acceptance model (TAM), this study differentiated between perceptions of ChatGPT and GPT-VMCS by assessing how these perceptions, along with doctor satisfaction, resistance, and ChatGPT usage, affect adoption intentions. Among the 2150 participants from 21 countries, 1038 who had used ChatGPT or observed its use were selected for hypothesis testing. The results indicated that the perceived usefulness (PU) of the GPT-VMCS was the strongest predictor of adoption intentions, with the perceived ease of use (PEOU) also playing a critical role. In contrast, resistance, which was positively influenced by doctor satisfaction, was negatively associated with adoption intentions. The quality of ChatGPT responses was positively correlated with GPT-VMCS PU, although direct usage of ChatGPT did not significantly affect adoption intentions. The study concludes with a discussion of both theoretical and practical implications.

Coronavirus disease and assisted reproduction in South Africa: a qualitative study

Objective: Little has been written about the effects of the coronavirus disease 2019 (COVID-19) pandemic on assisted reproduction services in low and middle-income countries. The purpose of this study was to investigate the immediate and long-term effects of assisted reproductive technology services in South Africa after 27 months of various lockdowns and restrictions associated with the pandemic. Methods: This article draws on data collected in 2020–2023 as part of a qualitative study of assisted reproduction within sub-Saharan Africa. Twenty-nine infertility specialists and other clinical staff including embryologists, clinic coordinators, ova donor coordinators, and nurses were interviewed and asked about the effects of the pandemic on their clinics and patients. A semistructured in-depth interview technique was used to collect the data. The analysis was conducted using the thematic analysis method. Result: Findings revealed that the immediate effects of the pandemic included the cancellations and deferral of assisted reproductive technology cycles and decreased numbers of cross-border patients. Challenges experienced by clinics in making decisions included whether to treat COVID-positive patients, increased costs of testing, and economic losses. Longer-term effects included the reconsideration of life priorities by both specialists and patients, and improved remote consultations and networking opportunities facilitated by the widespread dissemination of online platforms. There was also increased acceptability of the shipping and use of frozen gametes, leading to a perceived growth of the South African frozen oocyte trade. There was also decreased demand for add-ons, associated with the economic downturn post-pandemic in the region. Conclusion: COVID-19 carried costs (cancellation of cycles, a decrease in international patients, decrease in some procedures with the post-COVID economic downturn) but also unanticipated benefits for the practices and provision of services within infertility clinics in South Africa (increased gamete and embryo shipping; virtual patient consultations; improved virtual networking; greater use of local in vitro fertilization services). Further comparisons postpandemic in other low and middle-income countries are needed to understand the long-term implications.

ASTROMARG

ABSTRACT— The ASTROMARG research organization website outlines the detailed specifications and requirements for the development of a dynamic and feature- rich web platform. It defines the functional and non-functional requirements, user interfaces, and system behaviour necessary to create a user-friendly, informative, and secure online presence for the ASTROMARG research organization. This platform aims to serve as a comprehensive online resource for client and visitors, offering valuable information about the ASTROMARG’s services, facilitating virtual consultations, and providing a seamless e-commerce experience. INDEX TEARMS –Astrology, Numerology, Vastu Shastra .

Primary care optometry-based diabetic retinopathy review clinics - a new model of care and comparison with virtual diabetic retinopathy clinics.

Given the increasing prevalence of diabetes and diabetic retinopathy (DR) in the UK, this study evaluates a novel primary care optometry-based DR review service against traditional hospital-based virtual DR clinics. In the hospital-based virtual DR service, patients attended for data capture (visual acuity, fundus photography, macular OCT scanning) with asynchronous review at a later data by a hospital clinician. In the primary care optometry DR review clinic, patients attended an optometry practice for a face-to-face(F2F) review (with imaging) by an optometrist with additional training in DR. Data from both clinic types were analysed. Metrics included DR grading, management plans, grading concordance between primary care optometrists and consultant ophthalmologists, and the assessment of "ungradable" retinopathy referrals. One thousand seven hundred and sixty patients attended the virtual clinic between January 2021 and September 2023.954 patients attended the primary care review clinic between August 2022 and September 2023. Grading agreements between primary care optometrists and hospital consultants on those patients referred for consultant opinion were significant with Weighted Kappa scores of 0.61(95% CI 0.52-0.69) for DR grade and 0.69(95% CI 0.56-0.82) for diabetic macular oedema (DMO) status. Additionally, the primary care optometry clinic reported a considerably reduced non-attendance rate of 5%, in contrast to 21% in virtual clinics. The primary care optometry-based DR service emerges as an efficient, safe alternative to hospital services. It offers notable advantages over virtual clinics and addresses a care gap for those unsuitable for virtual consultations. The results highlight the potential of primary care-based models in managing DR.

Education and training programs for health professionals' competence in virtual consultations: a scoping review protocol.

Digital solutions, telemedicine, and technologies are increasingly becoming a part of the health system, requiring current and future health professionals to master skills in these domains. The objective of this scoping review is to explore, report, and map the evidence on education and training programs for current and future health professionals' competence in virtual consultations. This review will consider any studies on education and training programs designed to optimize current and future health professionals' competence in virtual consultations in any setting, such as faculties, universities, university colleges, hospitals, or community locations. This review will be guided by the JBI methodology for scoping reviews. Published and unpublished sources of information will be searched for in MEDLINE (PubMed), CINAHL Complete (EBSCOhost), and Scopus. Studies written in English, German, Danish, Swedish, and Norwegian will be considered, with no geographical or cultural limitations. Two independent reviewers will screen retrieved papers, and a standardized tool will be used to extract data from each included source. The results of the extracted data will be presented in tabular format, together with a narrative summary of the evidence. https://doi.org/10.17605/OSF.IO/BSMUY.

Outcomes and patient perspectives of a novel virtual spinal referral pathway in a non-specialist centre

IntroductionIn Irish orthopaedic centres without dedicated spinal services, the care of patients is facilitated through tertiary referral centres in Dublin, Cork & Galway. The outpatient waiting list for elective spinal opinion remains lengthy and challenging. Previous practice in University Hospital Waterford (UHW) necessitated an assessment with a local non-spinal orthopaedic specialist following a GP referral, incurring up to a 2-year wait prior to subspecialist spinal referral. These patients subsequently incurred a further wait for an appointment at the tertiary referral centre. A novel virtual spine clinic in collaboration with the Mater Misericordiae University Hospital (MMUH) was developed to fast-track this process.Aims and methodsA retrospective study was performed to audit efficiency by assessing time to initial consultation and time to virtual consultation, treatment outcomes, and patient satisfaction using an adapted patient-satisfaction questionnaire (PSQ-18) and a semi-structured interview. This study reflected the unique nature of patient experience in this pathway.ResultsThe median time from referral to being seen in an in-person rapid access physiotherapist combined orthopaedic clinic was 185 days. The median time from initial consultation to virtual consultation was 36 days. The median time interval from virtual consultation to intervention was 110 days. Twenty percent of patients underwent surgery, 14% were further seen in the MMUH outpatients, 7% managed with the trial of physiotherapy, 7% required no follow-up, and 50% planned for radiologically guided spinal injections.Discussion and conclusionThis novel pathway is efficient for orthopaedic units without a dedicated spinal service. This can easily be replicated across other orthopaedic centres with minimal cost implications.

Investigating Patient Uncertainty in Virtual Consultation: A Content Analysis Study

Despite the benefits of conveniences and flexibilities, widespread adoption of virtual consultation systems remains elusive among patients. This exploratory study aims to uncover the underlying reasons behind this phenomenon by investigating patient uncertainties about virtual consultation and their impact on patient satisfaction. Leveraging a content analysis methodology, we scrutinize patient-generated online reviews on five prominent virtual consultation platforms. Our findings delineate the primary sources of patient uncertainty, ranked in descending order of significance: (1) ambiguity surrounding virtual consultation processes, (2) concerns regarding doctors' behavior, (3) challenges in articulating symptoms, (4) apprehensions regarding doctors' attitudes, (5) difficulties in understanding doctors, and (6) uncertainty about doctor’s feelings and emotions. Moreover, our analysis suggests a potential link between heightened uncertainties and patient dissatisfaction, albeit contingent on various factors, including perceived benefits and how virtual consultation systems address patient uncertainties. This study sheds light on the intricate dynamics of uncertainties in virtual consultations, providing valuable insights for researchers, system designers, and healthcare providers. By elucidating patient perspectives and apprehensions, our findings offer a roadmap for refining virtual consultation systems to mitigate uncertainties and enhance patient satisfaction, thereby advancing the quality and efficacy of telemedicine services.

Increasing the use of telemedicine: A field experiment.

Patients are reluctant to use telemedicine health services, compared to its substitute in-person visits. One reason is that telemedicine can be accurately evaluated and compared to its substitute only after the product has been adopted and experienced. As such, an intervention that increases the probability of a first experience can have lasting effects. This article reports the results of a randomized field experiment conducted in collaboration with a health insurance company. During the intervention, half of the households out of 3,469 in the sample received periodic e-mails with information about the available services. It effectively increased the take-up and demand for telemedicine. Within the first 8 months of the experiment, patients assigned to the treatment group were 6 percentage points more likely to have used the service at least once (and had about five times the odds of using telemedicine compared to those in the control group). Eight months after the start of the intervention, the number of virtual consultations by the treatment group was six times larger than that of the control group. These results, even if limited by the sample and context in which the intervention took place, provide additional evidence about how information interventions can increase technological take-up within the health sector and could serve as the stepping stone for evaluating the impact of telemedicine on health outcomes causally.

Beyond the Chair: Exploring the Boundaries of Teledentistry.

Teledentistry, a blend of dentistry and telecommunications used to provide dental care from a distance, holds great promise in enhancing public health, especially in reaching communities with limited access. However, putting it into practice has its own set of obstacles and background variables. It is frequently difficult to obtain dental treatment, especially in rural or economically underdeveloped areas. By removing geographical constraints and offering virtual consultations and diagnostics, teledentistry provides a solution. The quick development of technology, such as portable electronics and high-speed internet, has increased accessibility and efficiency in communication, which has aided in the acceptance of teledentistry. Getting traditional dental care can be costly, particularly for people without insurance. As an affordable substitute for traditional dental care, teledentistry may lower overhead expenses related to physical dental offices. Early interventions and preventive care can greatly enhance oral health results and lessen the need for later, more invasive procedures. There are disparities in the availability of digital gadgets and internet connectivity. The laws that control telehealth services might differ greatly between nations and areas. While teledentistry can help with remote consultations and triage, it might not be able to do thorough examinations or other diagnostic treatments that need in-person attendance. Delivering dependable, top-notch telemedicine services in developing areas can pose challenges. Certain dentists might hesitate to utilize teledentistry due to concerns about the quality of care, liability issues, or potential impacts on their traditional practice models. It could be difficult to get patients to accept and use teledentistry services. This review is undertaken to assess the effectiveness of teledentistry in public health as well as legal and regulatory considerations for practicing teledentistry. Teledentistry might be the future of the oral health sector, thus fully capitalizing on this enormous opportunity to change how oral therapies are administered. Patients, dentists, and the dental community at large will need to have highly open minds. For the community's well-being and to gain its trust, ethical considerations are crucial. The outcomes of teledentistry can be attained by overcoming the obstacles and using comprehensive methods and approaches. It was noted that teledentistry is a potential strategy that combines dental care with telecommunication technology to enhance patient outcomes, reduce healthcare inequalities, and expand access to oral health services. The delivery of oral healthcare is being revolutionized by teledentistry, especially in light of contemporary issues including geographic restrictions, lack of access to dental treatment, and the ongoing global health crisis.

Development of Marketing Strategies with Digital Enhancements to Increase Patients’ Buying Decision in a Fertility Center

Infertility is a significant global concern, affecting a substantial portion of the adult population. Defined as the inability of a married couple to achieve pregnancy after 12 months of regular unprotected intercourse, its prevalence is increasing worldwide. According to the World Health Organization’s 2023 data, one in six adults experiences infertility, with notable variations across income brackets. Indonesia also faces this issue, affecting 10–15% of reproductive-age couples. This research examines the critical role of marketing strategies, specifically the 7Ps marketing mix (Product, Price, Place, Promotion, People, Physical Evidence, and Process), in influencing consumer buying decisions in fertility centers. The study aims to identify key factors that significantly impact patient choices and propose strategic improvements to enhance patient acquisition and retention. Utilizing Partial Least Squares Structural Equation Modeling (PLS-SEM), this research evaluates the relationship between marketing mix components and patient decisions. The findings highlight the importance of competitive pricing, effective promotion, high-quality staff, and efficient service processes in attracting patients. Additionally, it underscores the need for facility improvements, continuous service quality enhancement, and ensuring access to fertility centers. Furthermore, the role of digitalization in enhancing marketing strategies is critical. Incorporating digital tools and AI can significantly improve patient engagement, streamline administrative processes, and provide personalized care. By leveraging digital platforms for promotions, virtual consultations, and patient follow-ups, fertility centers can enhance their reach and service efficiency. This integration of digital solutions is crucial for staying competitive in a rapidly evolving healthcare market. This study provides actionable insights for fertility centers to refine their marketing strategies, including digitalization to improve patient acquisition and retention.

Virtual robotic telepresence early childhood mental health consultation to childcare centers in the aftermath of COVID-19: training approaches and perceived acceptability and usefulness.

Childcare center closures during COVID-19 impacted education for approximately 40 million children nationwide. Unfortunately, COVID-19 restrictions significantly limited the extent that outside personnel could provide in-person support to educators, resulting in the need for innovative approaches to meet childcare centers' needs. A virtual robotic telepresence approach was applied to early childhood consultation models to promote child resilience while mitigating COVID-19 risks. The goal of this study was to examine how training influenced consultants' and childcare staff uptake of the virtual robotic telepresence consultation approach and their acceptance of this technology. Ten early childhood consultants received multimedia/simulation training and weekly communities of practice related to virtual telepresence robotic consultation. Telepresence robotic consultation equipment was deployed to 16 childcare centers in a diverse multilingual metropolitan area as a part of a larger randomized controlled trial. Consultants trained childcare staff (14 center directors and 58 teachers) on how to receive virtual telepresence robotic consultation. Demographic information and measures of technology acceptability and uptake were collected from childcare staff and consultants. A mixed methods approach was used including multilevel modeling and focus groups to examine consultation uptake, acceptability, barriers, and facilitators of virtual telepresence robotic consultation implementation. Consultants and childcare staff generally perceived the virtual telepresence consultation approach to be useful and easy to use. Consultant perceptions of the acceptability of technology did not change over time. Childcare staff, center, and consultant factors impacted the uptake of the virtual robotic telepresence consultation approach and childcare staff acceptance of the technology. Focus groups revealed that consultants believed that additional hands-on training with childcare staff would have benefited implementation and expressed a desire for a hybrid approach for consultation. Perceptions of telepresence robotic consultation acceptability are discussed, including future recommendations for training.

Use of computer simulation to identify effects on hospital census with reduction of transfers for non-procedural patients in community hospitals

ObjectiveIn-person healthcare delivery is rapidly changing with a shifting employment landscape and technological advances. Opportunities to care for patients in more efficient ways include leveraging technology and focusing on caring...

Patients' Experience of Using Virtual Consultations in Their Care During Their Inpatient Stay on Acute Mental Health Admission

Patients' Experience of Using Virtual Consultations in Their Care During Their Inpatient Stay on Acute Mental Health Admission

DIET2TREAT: A randomized, multi-center, phase 2 trial of a ketogenic diet vs standard dietary guidance in combination with standard-of-care treatment for patients with newly diagnosed glioblastoma.

TPS2103 Background: Presented with a dismal prognosis and limited treatment options, many glioblastoma (GBM) patients seek complementary interventions. Of particular interest is a high-fat / low-carbohydrate diet known as the ketogenic diet (KD). Preclinical models and results from early-phase trials suggest potential benefits with KD for patients with GBM receiving standard-of-care (SOC) treatment, but definitive evidence of clinical efficacy is still lacking. Methods: We are conducting a multicenter randomized controlled phase 2 clinical trial of KD vs standard dietary guidance (SD) for patients with newly diagnosed GBM. All patients will receive SOC chemoradiation. Patients with newly diagnosed GBM age ≥ 18 years with Karnofsky Performance Status ≥ 70 are eligible. Exclusion criteria include inability to wean steroids below 8 mg dexamethasone/day or equivalent, Body Mass Index < 21 kg/m2, or food preferences incompatible with KD. Patients are randomized 1:1 to implement either KD (3:1 ratio between grams of fat to grams of carbohydrates + protein) or SD (based on guidelines from the American Cancer Society and American Institute of Cancer Research) for a study period of 18 weeks, starting the same time as chemoradiation. Post-randomization, all patients receive diet education, followed by in-person or virtual dietitian consultation every 2 weeks at minimum while on study. The primary objective is to assess overall survival for patients on the KD arm vs the SD arm. Secondary endpoints include assessments of progression-free survival, health-related quality-of-life (FACT-BR, FACIT-F), cognitive performance (HVLT-R, Trail-Making Test A/B), and physical activity (modified Godin leisure questionnaire, continuous activity monitoring (Fitbit)), as benefits in any of these domains would be impactful for patients. Patients randomized to the KD arm will be provided a fingerstick monitor (Keto-Mojo) to check blood ketone and glucose levels daily. Glucose and ketone levels are also periodically monitored for patients on the SD arm. Blood, tumor, and stool samples are being collected for high throughput profiling to assess the effects of KD on metabolic markers and immune response. While the primary analysis for this study is intent-to-treat, we will also perform secondary per protocol and as-treated analyses using food diaries plus glucose and ketone data. Target accrual is 170 patients over 5 years. Enrollment began in July 2023 and is ongoing. As of January 2024, the trial is open for enrollment at Cedars-Sinai Medical Center and will be opening at UCSF, Duke, Pacific Neuroscience Institute, and the Medical College of Wisconsin soon. Ten patients have been randomized so far. This trial is funded by NIH R01CA276919 and a grant from the Foundation for Metabolic Cancer Therapies and is registered as NCT05708352. Clinical trial information: NCT05708352 .

The unmet needs of women with metastatic breast cancer in Mexico: A qualitative study.

e13547 Background: Patients with metastatic breast cancer (mBC) have distinct unmet needs compared to those with early-stage disease. Recognizing this population's unique priorities is imperative to identify areas of opportunity to improve their care. This study aimed to explore the experiences and unmet needs of Mexican patients with mBC, a population for which information is scant. Methods: Patients aged ≥18 years with a diagnosis of mBC receiving systemic therapy or palliative care at a tertiary care center in Mexico City were invited to participate in a semi-structured interview. Those with intellectual disability, severe psychologic disorder, poor functional status (ECOG > 2), or not interested in participating were excluded. Results: Of 13 patients interviewed (median age: 50 years), 46% had an educational level of middle school or lower, 50% were unemployed, 39% were in a relationship, and 23% were not undergoing active treatment. Key unmet needs emerged in 3 domains: (A) Information: The patients noted that the medical team was willing to provide information about their disease, but often the explanations provided were overly technical or lacked detail. They expressed a desire for clearer communication about their prognosis and treatment options, but also wanted to limit the information received to minimize delivery of bad news. (B) Physical/emotional: The patients emphasized the need for readily available and accessible medications, regardless of institutional affiliation or place of residency. They noted that more widespread knowledge about available services (e.g., nutrition, dentistry, psychology) was necessary and wanted to explore complimentary medicine interventions that could help address their symptoms. The patients expressed a desire for immediate psychological support to be offered when initially diagnosed with distant disease and identified interaction with women going through similar circumstances as useful. (C) Navigating daily life: The patients noted a need to receive financial assistance for non-drug medical costs (e.g., nutritional supplements), as well as for transportation to and from medical appointments. They also identified lack of assistance with household chores and childcare as potential areas of improvement. They recognized virtual consultations as an attractive alternative to in-person appointments that could decrease time-toxicity and expenses. Conclusions: This study is the first qualitative exploration of unmet needs among Mexican women with mBC. Our findings highlight multifaceted unmet needs that patients experience and may negatively impact quality of life. Further research and the development of targeted interventions that aim to address pervasive gaps in clinical communication, emotional support, financial assistance, and supportive care access is urgently needed to alleviate distress in this vulnerable population.

Revolutionizing community health literacy: The power of digital health tools in rural areas of the US and Africa

Access to quality healthcare remains a challenge in rural areas of both the United States and Africa, where limited resources and infrastructure hinder the delivery of essential services. This review explores the role of digital health tools in improving community health literacy and healthcare outcomes in these underserved regions. By leveraging digital technologies such as mobile applications, telemedicine, and educational platforms, communities can access valuable health information, connect with healthcare providers remotely, and receive timely support for managing their health. In rural areas of the United States, digital health tools have the potential to bridge the gap between patients and healthcare providers, especially for those living in remote areas with limited access to healthcare facilities. These tools enable individuals to monitor their health conditions, access educational resources, and receive virtual consultations, improving their overall health literacy and empowering them to take control of their health. Similarly, in rural Africa, where healthcare infrastructure is often lacking, digital health tools offer a lifeline for communities to access essential health services. Mobile health applications provide valuable information on preventive care, disease management, and nutrition, helping individuals make informed decisions about their health. Telemedicine services connect patients with healthcare professionals, enabling remote consultations and reducing the need for travel to distant healthcare facilities. However, the widespread adoption of digital health tools in rural areas faces several challenges, including limited internet connectivity, low digital literacy rates, and cultural barriers. Addressing these challenges requires a multi-faceted approach, including improving internet infrastructure, providing digital literacy training, and adapting digital health tools to meet the cultural and linguistic needs of local communities. In conclusion, digital health tools have the potential to revolutionize community health literacy in rural areas of the United States and Africa. By overcoming barriers to access and providing tailored health information and services, these tools can empower individuals to make informed decisions about their health, ultimately leading to improved health outcomes and well-being in underserved communities.

Epidemic preparedness and innovations in digital healthcare: enhancing post-pandemic speech-language pathology services for child and adolescent mental health in Qatar

BackgroundThis paper discusses the critical importance of epidemic preparedness and innovations in digital health care by examining the transformative impact on speech-language pathology (SLP) services in a specialist outpatient child and adolescent service (CAMHS).MethodThis retrospective review analyzes referral data from three periods: pre-pandemic (15 March 2019–14 March 2020), pandemic (15 March 2020–14 March 2021), and post-pandemic (15 March 2021–14 March 2022). Statistical analyses assess trends in referrals and diagnoses during these periods. Feedback was also obtained from Parents of children who received virtual consultations during the pandemic.ResultsThe results reveal an increase in the demand for SLP services during and after the pandemic, with a surge in referrals (increased from 9.7 to 12.9% when compared pre-pandemic to post-pandemic periods; Chi-Square value 3.33, P = 0.068) for children with social communication challenges and autism spectrum disorder. Phone and video consultations were effectively adopted. Feedback from families shows a positive response (69%–98% of participants responded as strongly agreed and agreed on various items listed in feedback form specifically designed in line with the service objectives) to telehealth interventions, with many parents finding virtual consultations effective and helpful.ConclusionsThe study emphasizes the importance of telehealth SLP services in meeting the increasing demand for mental health interventions among children and adolescents. It suggests integrating telehealth into clinical practice beyond the pandemic and highlights the need for long-term evaluation and addressing potential barriers to access.

P.013 Accuracy of clinical assessments with virtual care in outpatient neurological setting

Background: Virtual neurological assessments were increasingly used and an important viable option during the COVID-19 pandemic. However, the accuracy of such assessments is unknown. Methods: Clinical records were reviewed in a predominant multiple sclerosis outpatient clinic at an academic teaching hospital from March 23rd 2020 to March 23rd 2021 during the COVID-19 pandemic. Patients assessed during this period were analyzed with an initial virtual assessment compared to subsequent in person evaluations. Results: 1036 patients were included. 27.8% (n=288) of consultations were video and 72.2% (n=748) telephone. A total of 13.8% (n=143) of virtual consultations revealed clinical disparities, specifically 13.5% (n=39) video and 13.9% (n=104) telephone consultations. Of all the 1036 cases, 2.32% (n=24) patients stated they were stable but significant changes were seen on the exam, changing the clinical impression. 11.5% (n=119) stated they were deteriorating virtually but not confirmed when examined in person, with an alternative explanation found. Conclusions: Virtual assessments were accurate in over 85% of the outpatient neurological cases during the pandemic. However, it should be noted that the in person neurological exam led to a change in clinical opinion in 13.8% of assessments. 2.32% patients described clinical stability, but different clinical management plans resulted when significant exam findings were identified.