Telehealth Practice Among Health Centers During the COVID-19 Pandemic — United States, July 11–17, 2020

Demeke, Hanna B.; Pao, Leah Zilversmit; Clark, Hollie; Romero, Lisa; Neri, Antonio; Shah, Rhea; McDow, Kendra B.; Tindall, Erica; Iqbal, Naureen; Hatfield-Timajchy, Kendra; Bolton, Joshua; Le, Xuan Thi Thanh; Hair, Brionna Y.; Campbell, Stephanie; Bui, Cuong J.; Sandhu, Paramjit; Nwaise, Isaac; Armstrong, Paige A.; Rose, Michelle A.

doi:10.15585/mmwr.mm6950a4

Cited by 90 publications

(84 citation statements)

References 3 publications

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“…Health centers have expanded telehealth visits considerably; nearly one third of health visits were conducted using telehealth during the study period. According to 2019 Health Center Program Data, ¶¶ 43% of health centers were capable of providing telemedicine, compared with 95% of the health centers that reported using telehealth during the COVID-19 pandemic ( 1 ). The largest increase in use of telehealth was reported in April 2020 ( 4 , 5 ).…”

Section: Discussionmentioning

confidence: 99%

“…Telehealth can facilitate access to care, reduce risk for transmission of SARS-CoV-2 (the virus that causes coronavirus disease 2019 [COVID-19]), conserve scarce medical supplies, and reduce strain on health care capacity and facilities while supporting continuity of care. Health Resources and Services Administration (HRSA)–funded health centers * expanded telehealth † services during the COVID-19 pandemic ( 1 ). The Centers for Medicare & Medicaid Services eliminated geographic restrictions and enhanced reimbursement so that telehealth services–enabled health centers could expand telehealth services and continue providing care during the pandemic ( 2 , 3 ).…”

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confidence: 99%

“…CDC and HRSA analyzed data from 245 health centers that responded to the Health Center COVID-19 Survey for 20 consecutive weeks (weeks ending June 26–November 6, 2020) to examine trends in telehealth use, assess differences by U.S. Census region ¶ and urbanicity, ** and compare telehealth patterns with the 7-day average number of new known COVID-19 cases within the counties where the included health centers were located. Region and urbanicity have previously been shown to be strongly associated with telehealth use ( 1 ). Each health center recorded the percentage of weekly telehealth visits in intervals of five (range = 0–100).…”

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confidence: 99%

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Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic — United States, June 26–November 6, 2020

Demeke¹,

Merali²,

Marks³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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164

135

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic — United States, June 26–November 6, 2020

Demeke¹,

Merali²,

Marks³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

Self Cite

164

135

View full text Add to dashboard Cite

“…As SARS-CoV-2 infections surge across the globe, these findings validate the key role of telehealth visits during a pandemic and the need for healthcare organisations to prepare for widespread implementation of telemedicine capabilities. 35 Further, the sustained application of telemedicine highlights the importance of continued research into its best uses. 36 In particular, as the need for post-COVID-19 clinics increases, expanding telehealth availability would allow more patients to be evaluated, especially those who are unable or unwilling to attend an inperson visit.…”

Section: Discussionmentioning

confidence: 99%

Characterising the long-term clinical outcomes of 1190 hospitalised patients with COVID-19 in New York City: a retrospective case series

et al. 2021

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ObjectiveTo characterise the long-term outcomes of patients with COVID-19 admitted to a large New York City medical centre at 3 and 6 months after hospitalisation and describe their healthcare usage, symptoms, morbidity and mortality.DesignRetrospective cohort through manual chart review of the electronic medical record.SettingNewYork-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical centre in New York City.ParticipantsThe first 1190 consecutive patients with symptoms of COVID-19 who presented to the hospital for care between 1 March and 8 April 2020 and tested positive for SARS-CoV-2 on reverse transcriptase PCR assay.Main outcome measuresType and frequency of follow-up encounters, self-reported symptoms, morbidity and mortality at 3 and 6 months after presentation, respectively; patient disposition information prior to admission, at discharge, and at 3 and 6 months after hospital presentation.ResultsOf the 1190 reviewed patients, 929 survived their initial hospitalisation and 261 died. Among survivors, 570 had follow-up encounters (488 at 3 months and 364 at 6 months). An additional 33 patients died in the follow-up period. In the first 3 months after admission, most encounters were telehealth visits (59%). Cardiopulmonary symptoms (35.7% and 28%), especially dyspnoea (22.1% and 15.9%), were the most common reported symptoms at 3-month and 6-month encounters, respectively. Additionally, a large number of patients reported generalised (26.4%) or neuropsychiatric (24.2%) symptoms 6 months after hospitalisation. Patients with severe COVID-19 were more likely to have reduced mobility, reduced independence or a new dialysis requirement in the 6 months after hospitalisation.ConclusionsPatients hospitalised with SARS-CoV-2 infection reported persistent symptoms up to 6 months after diagnosis. These results highlight the long-term morbidity of COVID-19 and its burden on patients and healthcare resources.

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“…For example, the COVID-19 pandemic has necessitated a shift in healthcare delivery resulting in stakeholders rapidly deploying and increasing their reliance on telehealth, an alternative to inperson care. Telehealth can facilitate access to care, reduce risk of transmission, conserve scarce medical supplies, and reduce strain on health care capacity and facilities while supporting continuity of care (22). During the COVID-19 Emergency, CMS issued temporary measures to make it easier for people enrolled in Medicare, Medicaid, and CHIP to receive medical care through telehealth services during the duration of the Emergency.…”

Section: Benefits Of Using a Learning Health Policy Systemmentioning

confidence: 99%

Policy Implementation Science to Advance Population Health: The Potential for Learning Health Policy Systems

Abazeed

Chambers

2021

Front. Public Health

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Many health policies are designed with the intention of improving health outcomes for all. Yet implementation of policies are variable across contexts, potentially limiting its impact on population health outcomes. The potential impact of a policy to advance health equity depends both on the design and its implementation, requiring ongoing evaluation and stakeholder engagement. Despite the importance of health policies in shaping public health, health care policy implementation science remains underrepresented in research. We argue that enhanced integration of policy questions within implementation science could reduce the time lag from policy to practice and improve population health outcomes to build a body of evidence on effective policy implementation. In this commentary, we argue that approaches to studying policy implementation science should reflect the dynamic and evolving policy context, analogous to the “learning healthcare system,” to better understand and respond to systematic and multilevel impacts of policy. Several example opportunities for a learning health policy system are posed in building a broader agenda toward research and practice in policy implementation science in public health.

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Telehealth Practice Among Health Centers During the COVID-19 Pandemic — United States, July 11–17, 2020

Cited by 90 publications

References 3 publications

Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic — United States, June 26–November 6, 2020

Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic — United States, June 26–November 6, 2020

Characterising the long-term clinical outcomes of 1190 hospitalised patients with COVID-19 in New York City: a retrospective case series

Policy Implementation Science to Advance Population Health: The Potential for Learning Health Policy Systems

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