Predictors of Telemedicine Utilization in a Pediatric Neurosurgical Population During the COVID-19 Pandemic

Lambert, William A.; Leclair, Nathan K.; Knopf, Joshua; Mosha, Maua; Bookland, Markus J.; Martin, Jonathan E.; Hersh, David S.

doi:10.1016/j.wneu.2021.06.120

Cited by 10 publications

(4 citation statements)

References 32 publications

(40 reference statements)

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“…Our results were in agreement with current literature suggesting that it is feasible to maintain a high volume of outpatient practice via telehealth and appropriately triage which patients need to be seen in person [ 15 , 16 ]. Here, we present our experience with adopting telemedicine, only in the form of telephone appointments, during the early stages of the pandemic.…”

Section: Discussionsupporting

confidence: 92%

“…Barriers and challenges of this evolving practice have been recently evaluated and reported, leading to very promising results. The use of telehealth has proven to be a very important tool in caring Our results were in agreement with current literature suggesting that it is feasible to maintain a high volume of outpatient practice via telehealth and appropriately triage which patients need to be seen in person [15,16]. Here, we present our experience with adopting telemedicine, only in the form of telephone appointments, during the early stages of the pandemic.…”

Section: Discussionsupporting

confidence: 89%

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The impact of telephone consultations due to COVID-19 on paediatric neurosurgical health services

et al. 2022

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Purpose The aim of the study was to evaluate the role of telephone consultations due to the pandemic in the management of paediatric neurosurgical patients and, furthermore, to examine the proportion of patients who eventually needed a face-to-face appointment and assess the underline reasons for that. Methods This retrospective study included all the paediatric neurosurgical patients who had a telephone appointment during a 3-month lockdown period. Overall, 319 patients (186 males and 133 females) aged 8.36 ± 4.88 (mean ± SD) had a consultation via telephone. Two hundred fifty-one (78.7%) patients had a follow-up assessment and 68 (21.3%) were new appointments. Results Patients were divided between two main groups. Group A included 263 patients (82.4%) whose consultation was adequate via telephone, and Group B included 56 patients (17.6%) who required a complementary face-to-face appointment. Patients who were more likely to require a supplementary appointment were patients with either dysraphism or ventriculomegaly and benign enlarged subarachnoid spaces (BESS) (43.3% and 36.4%, respectively). Interestingly, most children with hydrocephalus who underwent a cerebrospinal fluid (CSF) diversion procedure and children with Chiari I malformation were appropriately assessed via telephone (85.1% and 83.3%, respectively). Finally, children aged < 2 years (55.2%) were better managed with face-to-face appointments. No difference was noticed regarding follow-up and new appointments. Conclusion Although telemedicine was not unknown to neurosurgical services, the actual application of telephone or video consultations remained quite limited. It was COVID-19 pandemic who reinforced the use of telemedicine, and taking into consideration its promising results, we can safely assume that it can be incorporated into neurosurgical health care even once the pandemic crisis has resolved.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

The impact of telephone consultations due to COVID-19 on paediatric neurosurgical health services

et al. 2022

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“…This use differs from the intended use of these tools as envisioned by developers and clinicians. Third, studies 23 , 24 have used fixed patient characteristics to predict the uptake of remote care. Future studies should assess the association of the time-varying criteria identified in our study with uptake.…”

Section: Discussionmentioning

confidence: 99%

Preferences for Alternative Care Modalities Among French Adults With Chronic Illness

et al. 2021

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IMPORTANCEThe COVID-19 pandemic led to the implementation of alternative care modalities (eg, teleconsultations and task shifting) that will continue to be implemented in parallel to traditional care after the pandemic. An ideal balance between alternative and traditional care modalities is unknown.OBJECTIVES To quantify the ideal postpandemic balance between alternative and traditional care modalities among patients with chronic illness and to qualify the circumstances in which patients consider it appropriate to replace traditional care with alternative care. DESIGN, SETTING, AND PARTICIPANTSThis survey study invited 5999 adults with chronic illness in ComPaRe, a French nationwide e-cohort of adults with chronic conditions who volunteer their time to participate in research projects, to participate in this study, which was performed from January 27 to February 23, 2021. MAIN OUTCOMES AND MEASURESParticipants rated the ideal proportion at which they would use 3 alternative care modalities instead of the traditional care equivalent on a 0% to 100% scale (with 0% indicating using alternative care modalities for none of one's future care and 100% indicating using alternative care modalities for all of one's future care) of their overall future care: (1) teleconsultations, (2) online symptom-checkers to react to new symptoms, and (3) remote monitoring to adapt treatment outside consultations. The median ideal proportion of alternative care use was calculated. Perceived appropriate circumstances in which each alternative modality could replace traditional care were collected with open-ended questions. Analyses were performed on a weighted data set representative of patients with chronic illness in France. RESULTS Of the 5999 invited individuals, 1529 (mean [SD] age, 50.3 [14.7] years; 1072 [70.1%]female) agreed to participate (participation rate, 25.5%). Participants would choose teleconsultations for 50.0% of their future consultations (IQR, 11.0%-52.0%), online symptomcheckers over contacting their physician for 22.0% of new symptoms (IQR, 2.0%-50.0%), and remote monitoring instead of consultations for 52.3% of their treatment adaptations (IQR, 25.4%-85.4%). Participants reported 67 circumstances for which replacing traditional with alternative care modalities was considered appropriate, including 31 care activities (eg, prescription renewal and addressing acute or minor complaints), 25 patient characteristics (eg, stable chronic condition and established patient-physician relationship), and 11 required characteristics of the alternative care modalities (eg, quality assurance). CONCLUSIONS AND RELEVANCEResults of this survey study suggest that after the pandemic, patients would choose alternative over traditional care for 22% to 52% of the time across different care needs. Participants proposed 67 criteria to guide clinicians in replacing traditional care with (continued) Key Points Question What is an ideal balance between alternative care modalities implemented during the COVID-19 pandemic and traditional care in...

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“…In the literature multiple recommendations are published on how to improve quality and how to improve the acceptance of telemedicine among both patients and health care providers ( Zu et al, 2020 ; Hsueh et al, 2021 ; Gachabayov et al, 2021 ; Lambert et al, 2021 ). In a well-written review paper by LoPresti et all, seven common problems with solutions were discussed on how to effectively apply telemedicine.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine use by neurosurgeons due to the COVID-19 related lockdown

2021

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Introduction Due to COVID-19 related restriction, the use of telemedicine has increased tremendously. With this increase, an evaluation in the neurosurgical field seems appropriate. Research question To what extent has telemedicine made its way in neurosurgical practice during the COVID-19 pandemic? Material and Methods A 29-question survey was distributed among members of the congress of neurological surgeons regarding (Barsom et al., 2020) the respondents demographics, (Zu et al., 2020) the current level of COVID-19 restrictions, (Greven et al., 2020) the current use of telemedicine and (LoPresti et al., 2020) potential difficulties and consequences of telemedicine for patient care. Results The average number of weekly outpatient visits decreased with 31 visits to a mean of 15 visits per week, while the average number of surgeries performed decreased with 5 to a mean of 2 procedures per week. On average 60% of the normal consultations have been converted to telehealth consults. Telemedicine was expected to increase the ability to quickly meet patients for urgent appointments (70%) but was also expected to decrease the quality of the relationship (56%) between practitioners and patients. The biggest difficulties due to use of telemedicine were the inability to perform physical examination (42%) followed by the inability of patients to use technology (24%) and working with elderly patients (20%). Discussion and Conclusion Telemedicine, however, comes with concerns regarding the quality of the relationship between patients and practitioners and regarding accessibility among certain patient groups. With these concerns, areas of improvement and further research are indicated. Due to the COVID-19 pandemic, telemedicine has become an integral part of the neurosurgical healthcare.

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Predictors of Telemedicine Utilization in a Pediatric Neurosurgical Population During the COVID-19 Pandemic

Cited by 10 publications

References 32 publications

The impact of telephone consultations due to COVID-19 on paediatric neurosurgical health services

The impact of telephone consultations due to COVID-19 on paediatric neurosurgical health services

Preferences for Alternative Care Modalities Among French Adults With Chronic Illness

Telemedicine use by neurosurgeons due to the COVID-19 related lockdown

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