Synchronous Telemedicine in Allergy: Lessons Learned and Transformation of Care During the COVID-19 Pandemic

Abstract

Background The outbreak of the COVID-19 pandemic facilitated a rapid transition to non-face-to-face models of care across the allergy services. Objective To describe the outcomes of the use of synchronous telemedicine for outpatient consultations in a tertiary adult allergy centre. Methods We retrospectively reviewed all non-face-to-face appointments during the second month of the pandemic in the UK. Results A total of 637 non-face-to-face appointments for unique patients were booked between 1 and 30 April 2020; 91% were new consultations. Most referrals (81.5%) were related to non-drug reactions. The overall ‘Did Not Attend’ rate was 15.7%. A total of 439 patients were assessed for non-drug reactions; 87% were new appointments. Food-related reactions (50.4%), urticaria/angioedema (23.2%) and rhinitis (18.1%) were the most common reasons for new referrals. Two hundred twenty-one (57.7%) of these patients required further allergy testing, primarily for suspected food allergy. More than 42% of the new patients, mainly referred for urticaria/angioedema, were discharged following their remote assessment. Less than 10% of the follow-up patients required additional testing. Ninety-seven new patients were assessed for a suspected drug reaction, predominantly to beta-lactam antibiotics (57.7%). Sixty-nine patients (71%) required further investigations, but a notable 29% did not require further allergy input. The overall experience was very good/good for most patients (85%). Conclusion Telemedicine can transform the current models of allergy care. Screening criteria for selecting suitable new patients are required. A telemedicine-based drug allergy service model can be more time- and cost-effective, and improve patient access to specialist care.

Speech-Language Pathology and Audiology in South Africa: Clinical Training and Service in the Era of COVID-19

“…The majority of the studies highlighted cost effectiveness as one of the significant benefits of remote clinical training and service provision ( Carrick et al, 2017 ; Chandrasinghe et al, 2020 ; Goehring et al, 2012 ; Harris & Sun, 2013 ; Likic et al, 2013 ; Thomas et al, 2021 ). Cost effectiveness was realized in different forms including travel time and expenses, demand versus capacity of staff and clinicians, and safe access environments.…”

“…Further work will be needed to confirm that this approach can accelerate autism diagnosis at scale. Thomas et al (2021) Synchronous telemedicine in allergy: Lessons learned and transformation of care during the COVID-19 pandemic. A total of 537 synchronous telephone encounters were conducted.…”

“…The use of teletraining and telepractice has increasingly been documented internationally. This has included their co-use in teaching both students and patients in assessment and management of chronic diseases within communities in primary healthcare ( Kolltveit et al, 2016 , Steventon et al, 2016 ), in assessment of both students and patients ( Cassel & Edd 2016 ; Giudice et al, 2015 ), in clinical supervision ( Batthish et al 2013 ; Cameron et al, 2015 ; Harris, 2020 ) – through the use of various measures including telephones ( Bunker et al, 2017 ; Thomas et al, 2021 ), online access ( Muflih et al, 2020 ); and videoconferencing ( Cameron et al, 2015 ; Howells et al, 2019 ), to name a few. The COVID-19 pandemic has raised the need for thorough deliberations around this method of service and training delivery ( Chandrasinghe et al, 2020 ; Grewal et al, 2020 ; Muflih et al, 2020 ), hence the current study.…”

The applications of eHealth technologies in the management of asthma and allergic diseases

“…Telemedicine received a tremendous boost in acceptance and utilization during the COVID‐19 pandemic. 78 The most heavily affected countries saw their allergy practices rapidly being converted to telemedicine within days. 79 In many cases, the radical change in practice had to happen without much of the needed preparation or advanced planning.…”

“…26 Telemedicine received a tremendous boost in acceptance and utilization during the COVID-19 pandemic. 78 The most heavily affected countries saw their allergy practices rapidly being T A B L E 3 Recommendations aimed at maintaining a professional social media presence…”