Could Telemedicine Be Here to Stay? Understanding the Rapidly Changing Landscape of Telemedicine in Allergy and Immunology Practice

Rehman, Narmeen; Portnoy, Jay M.; Wu, Ann Chen

doi:10.1016/j.jaip.2022.08.012

Cited by 1 publication

(3 citation statements)

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“… 4 , 14 Benefits of telemedicine include limiting provider and patient exposure to COVID-19 and expanding access to rural locations. 14 , 23 While at the same time providing added convenience, decreased wait times, and lower out-of-pocket transportation costs, telemedicine has also created the undeniable situation in which Internet access has become a significant social determinant of health. 23 Barriers to effective use of telemedicine include health and technologic literacy challenges and variations in how individual patients prefer to interact with health systems.…”

Section: Communicating Riskmentioning

confidence: 99%

“… 14 , 23 While at the same time providing added convenience, decreased wait times, and lower out-of-pocket transportation costs, telemedicine has also created the undeniable situation in which Internet access has become a significant social determinant of health. 23 Barriers to effective use of telemedicine include health and technologic literacy challenges and variations in how individual patients prefer to interact with health systems. 4 Some regulatory hurdles have been attenuated during the COVID-19 pandemic; however, the duration of current regulatory exceptions is unclear.…”

Section: Communicating Riskmentioning

confidence: 99%

“… 4 Some regulatory hurdles have been attenuated during the COVID-19 pandemic; however, the duration of current regulatory exceptions is unclear. 4 , 23 , 24 …”

Section: Communicating Riskmentioning

confidence: 99%

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Shared decision-making, communicating risk, and food allergy in 2023

Shaker

2023

Journal of Food Allergy

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Background: Across the practice of allergy and clinical immunology, disruptive innovations have accelerated the adoption of shared decision-making (SDM) to improve the health of patients and populations, particularly with regard to food allergy prevention and management of food allergy and anaphylaxis. Methods: A narrative review was performed to describe recent innovations in shared decision-making, risk communication, and food allergy. Results: Several challenges, primarily related to the coronavirus disease 2019 (COVID-19) pandemic and misinformation campaigns, have catalyzed adaptations to evolve clinical care. Recent pressures have facilitated the rapid adoption of telemedicine. In 2023, many allergist/immunologists routinely incorporate both in-person and virtual visits to contextually deliver value-based care to each patient. SDM may occur in a hybrid model that incorporates both in-person and virtual encounters, with many patients experiencing benefit from a combination approach. This may be facilitated by leveraging previsit web-based SDM tools. Whether in person or by telemedicine, effective risk communication to avoid cognitive overload while appreciating population variation in numeracy is key to competent implementation of SDM. Misinformation continues to disproportionately harm patients who belong to groups that encourage denial of evidence-based medical recommendations and COVID-19 vaccination intent correlating with sociopolitical factors. Still, strategies to address misinformation that leverage empathy, respect, and expertise can help to mitigate these effects. Physician wellness is a key component to realization of the Quadruple Aim of health care, and the use of positive framing and appreciative inquiry can help to optimize outcomes and improve value in health care. Conclusion: SDM is an important component to consider when incorporating recent innovations in allergy and clinical immunology care, particularly in the setting of contextual and conditional medical recommendations. Effective risk communication is critical to SDM that is truly reflective of patient goals and preferences, and can be facilitated through in-person encounters, telemedicine, and hybrid models. It is important to foster physician wellness as a component of the Quadruple Aim, particularly in the recent pandemic climate of misinformation and denial of evidence-based medicine within large groups of society.

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