Telehealth in urology after the COVID-19 pandemic

Gadzinski, Adam J.; Ellimoottil, Chad

doi:10.1038/s41585-020-0336-6

Cited by 52 publications

(43 citation statements)

References 9 publications

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“…Elective surgeries have been suspended and even cancer cases have been postponed, with the hope that such delay will not have a negative impact on patient's outcome (9). Telemedicine has become an important tool, reducing the exposure of patients and clinicians, but only a small fragment of practitioners was prepared for this and most patients do not openly accept this new way modality of evaluation (10,11). As a result, urologists and other surgical specialists have been experiencing a tremendous impact on their income, especially those whose earnings are driven mostly from their private practice (12).…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists

et al. 2020

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Objectives: To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. Materials and Methods: A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists' clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. Results: Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and nonessential surgeries (OR=2.95, 95% CI 1.86-4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012). Conclusions: COVID-19 produced massive disturbances in Brazilian urologists' practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians' income, health and personal lives. These findings are probably applicable to other medical specialties.

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Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists

et al. 2020

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“…40 Telemedicine (video visit, virtual check-in, eVisit, and eConsult) not only provides zero risk urology services during a pandemic but also has the potential to grow into telemonitoring (cystoscopy, video-urodynamic, radiodiagnosis) and telesurgery (robotic surgery). 51 Based upon the risk grading, a study in Germany found that 54.1% of the patients in Germany were eligible (based on risk grading) and willing for tele-consultation for urology care that will ensure "contact-free continuity of care". 25 Besides convenience, efficiency, and cost-utility the long-term quality health care (efficacy, safety, and equity) provided by the telehealth is not known.…”

Section: Discussionmentioning

confidence: 99%

Urology during COVID-19 Pandemic Crisis: A Systematic Review

Thapa

Shrestha²,

Bista

et al. 2021

Surg J (N Y)

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Background Coronavirus disease 2019 (COVID-19) has evolved as a pandemic of unimaginable magnitude. The health care system is facing a tremendous challenge to provide ethical and quality care. The transformation of the patient-based care to population-based care during the COVID-19 pandemic has raised ethical dilemma among urologists. Our objective is to explore the consensus in modified standard urology care, that can be adopted and applied during COVID-19 and similar pandemic. Methods We adopted an exploratory study design using secondary data. The data were extracted from a web-based medical library using keywords “COVID-19,” “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),” and “urology.” We identify and extrapolate (screening, eligibility, and inclusion) the data using PRISMA protocol, and summarize pandemic standard urology care under four main themes: (1) general urology care, (2) choice of surgical modality, (3) triage, and (4) urology training. Result We identified 63 academic papers related to our research question. The majority are expert opinions and perspectives on urology care. The common consensus is triage-based urology care and surgeries. Life or organ threatening conditions need immediate attention. Universal protective measures (personal protective equipment, safe operative environment) and protocol-based patient care are necessary to prevent and control SARS-CoV-2 infection. Conservation of the resources and its rational distribution provide an ethical basis for population-based health care during a pandemic. Informed decision making serves best to patients, families, and society during the public health crisis. Conclusion COVID-19 pandemic tends to transform standard urology practice into crisis standard population-based care. The consensus in crisis is drawn from evolving pieces of medical evidence and public health ethics. The provision of urology care during a pandemic is based on the availability of resources; severity of the disease, consequences of deferment of service, and dynamics of the pandemic.

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“…Actualmente existe un volumen de publicaciones creciente sobre la pandemia COVID-19. Algunas de estas publicaciones abordan el impacto del SARS-CoV-2 en pacientes urológicos, pero no existe información sobre la percepción y el impacto de la teleconsulta en los pacientes en la especialidad de urología [4][5][6] .…”

Section: Introductionunclassified