Rapid Transition to Virtual Care during the COVID-19 Epidemic: Experience of a Supportive Care Clinic at a Tertiary Care Cancer Center

Reddy, Akhila; Arthur, Joseph; Dalal, Shalini; Hui, David; Subbiah, Ishwaria Mohan; Wu, Jimin; Anderson, Aimée E.; Castro, Debra; Joy, Michael; Nweke, Chinelo; Gogineni, Meghana; Maddi, Rama; Moraes, Aline Rozman De; Shelal, Zeena; Bruera, Éduardo

doi:10.1089/jpm.2020.0737

Cited by 23 publications

(22 citation statements)

References 23 publications

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“…As cities and states across the United States reached peak COVID-19 cases and hospitalizations, health care systems relied on public health guidance to limit in-person patient appointments and services [ 61 , 62 ]. There has been a large increase in the adoption of the patient portal in terms of general use and depth of use [ 63 ], including substantial dependence on the use of telehealth platforms and portal messaging for care management of patients [ 61 , 64 ]. Medical information technology allowed health care providers a key method with which to continue accommodating patient services safely while reserving hospital capacity for the most critically ill.…”

Section: Discussionmentioning

confidence: 99%

Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey

Baek¹,

Simon-Friedt²,

López³

et al. 2021

J Med Internet Res

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Background Patient portals play an important role in connecting patients with their medical care team, which improves patient engagement in treatment plans, decreases unnecessary visits, and reduces costs. During natural disasters, patients’ needs increase, whereas available resources, specifically access to care, become limited. Objective This study aims to examine patients’ health needs during a natural crisis by analyzing the electronic messages sent during Hurricane Harvey to guide future disaster planning efforts. Methods We explored patient portal use data from a large Greater Houston area health care system focusing on the initial week of the Hurricane Harvey disaster, beginning with the date of landfall, August 25, 2017, to August 31, 2017. A mixed methods approach was used to assess patients’ immediate health needs and concerns during the disruption of access to routine and emergent medical care. Quantitative analysis used logistic regression models to assess the predictive characteristics of patients using the portal during Hurricane Harvey. This study also included encounters by type (emergency, inpatient, observation, outpatient, and outpatient surgery) and time (before, during, and after Hurricane Harvey). For qualitative analysis, the content of these messages was examined using the constant comparative method to identify emerging themes found within the message texts. Results Out of a total of 557,024 patients, 4079 (0.73%) sent a message during Hurricane Harvey, whereas 31,737 (5.69%) used the portal. Age, sex, race, and ethnicity were predictive factors for using the portal and sending a message during the natural disaster. We found that prior use of the patient portal increased the likelihood of portal use during Hurricane Harvey (odds ratio 13.688, 95% CI 12.929-14.491) and of sending a portal message during the disaster (odds ratio 14.172, 95% CI 11.879-16.907). Having an encounter 4 weeks before or after Hurricane Harvey was positively associated with increased use of the portal and sending a portal message. Patients with encounters during the main Hurricane Harvey week had a higher increased likelihood of portal use across all five encounter types. Qualitative themes included: access, prescription requests, medical advice (chronic conditions, acute care, urgent needs, and Hurricane Harvey–related injuries), mental health, technical difficulties, and provider constraints. Conclusions The patient portal can be a useful tool for communication between patients and providers to address the urgent needs and concerns of patients as a natural disaster unfolds. This was the first known study to include encounter data to understand portal use compared with care provisioning. Prior use was predictive of both portal use and message sending during Hurricane Harvey. These findings could inform the types of demands that may arise in future disaster situations and can serve as the first step in intentionally optimizing patient portal usability for emergency health care management during natural disasters.

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Section: Discussionmentioning

confidence: 99%

Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey

Baek¹,

Simon-Friedt²,

López³

et al. 2021

J Med Internet Res

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Section: Covid-19 and Its Effect On Health Care Delivery In Palliativ...mentioning

confidence: 99%

“…Our transition from in-person to telemedicine in March 2020 in response to the COVID-19 pandemic is an example of a successful process [23]. We conducted a retrospective chart review of 1744 consecutive patients seen between 14 February 2020, and 16 April 2020 [23]. The periods of interest were the four weeks before the transition to telemedicine, the oneweek transition, and four weeks after the transition.…”

Section: Covid-19 and Its Effect On Health Care Delivery In Palliativ...mentioning

confidence: 99%

Telemedicine and Its Past, Present, and Future Roles in Providing Palliative Care to Advanced Cancer Patients

Tang

Reddy

2022

Cancers

Self Cite

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The landscape of healthcare delivery has considerably changed due to the emergence of coronavirus disease 2019 (COVID-19). This is nowhere more evident than in the care of advanced cancer patients receiving palliative care. This population is susceptible to the severe complications of COVID-19, and immediate measures had to be taken to ensure their safety. Thus, the adoption of telemedicine as a health care delivery model emerged. This model provides many benefits, such as improved access to care while maintaining social distancing; however, there exist challenges to this model, including health care disparities, reimbursement, and monitoring of opioids in high-risk populations. This narrative review provides an overview of the unique benefits and barriers of telemedicine in palliative care patients.

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“…In consideration of the worldwide emergency situation, attempts have been made to provide TM service to these patients, leading to the publication of practical tips that cover TM setup and both patient and clinician considerations 12. Several recent papers have provided a description of the transition from in-person to TM visits, indicating the feasibility of providing continuity of care for palliative patients by also reducing their chances of contacting the virus 13–16. However, more information is needed regarding the impact of the implementation of this strategy on patient management and experience of care.…”

Section: Introductionmentioning

confidence: 99%

“… 12 Several recent papers have provided a description of the transition from in-person to TM visits, indicating the feasibility of providing continuity of care for palliative patients by also reducing their chances of contacting the virus. 13–16 However, more information is needed regarding the impact of the implementation of this strategy on patient management and experience of care.…”

Section: Introductionmentioning

confidence: 99%

Telemedicine for outpatient palliative care during COVID-19 pandemics: a longitudinal study

Caraceni

Pellegrini

Shkodra

et al. 2022

BMJ Support Palliat Care

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ObjectivesDuring the COVID-19 pandemic, telemedicine (TM) emerged as an important mean to reduce risks of transmission, yet delivering the necessary care to patients. Our aim was to evaluate feasibility, characteristics and satisfaction for a TM service based on phone/video consultations for patients with cancer attending an outpatient palliative care clinic during COVID-19 pandemics.MethodsA longitudinal observational study was conducted from April to December 2020. Consecutive patients were screened for video consultations feasibility. Either patients or their caregivers received video/phone consultations registering reason and intervention performed. Those contacted at least twice were eligible for experience of care assessment.ResultsVideo consultations were feasible in 282 of 572 screened patients (49%, 95% CI 45% to 52%); 112 patients among the 572 had at least two phone/video consultations and 12 of them had one or more video consultations. Consultations were carried out with patients (56%), caregivers (30%) or both (14%). 63% of the consultations were requested by the patients/caregivers. Reasons for consultation included uncontrolled (66%) or new symptom onset (20%), therapy clarifications (37%) and updates on diagnostic tests (28%). Most interventions were therapy modifications (70%) and appointments’ rescheduling (51%). 49 patients and 19 caregivers were interviewed, reporting good care experience (average of 1–5 satisfaction score of 3.9 and 4.2, respectively). The majority (83% and 84%) declared they would use TM after the pandemics.ConclusionsAlthough feasibility is still limited for some patients, TM can be a satisfactory alternative to in-person visits for palliative care patients in need of limiting access to the hospital.

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Rapid Transition to Virtual Care during the COVID-19 Epidemic: Experience of a Supportive Care Clinic at a Tertiary Care Cancer Center

Cited by 23 publications

References 23 publications

Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey

Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey

Telemedicine and Its Past, Present, and Future Roles in Providing Palliative Care to Advanced Cancer Patients

Telemedicine for outpatient palliative care during COVID-19 pandemics: a longitudinal study

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