Telemedicine in acute stroke

Handschu, René; Scibor, M.; Willaczek, Barbara; Nückel, Martin; Heckmann, Josef G.; Asshoff, Dirk; Belohlavek, Dieter; Erbguth, Frank; Schwab, Stefan

doi:10.1007/s00415-008-0066-9

Cited by 56 publications

(11 citation statements)

References 16 publications

(8 reference statements)

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“…In another case, a web-based structured format to upload patient-related information was established to determine the effect of teleconsultation in cases of strabismus ( 48 ). In two other cases, a structured interview was performed in acute stroke care by telephone consultation ( 62 ) and a standardized query form (including all relevant clinical information) were designed for teledermatology consultation ( 52 ).…”

Section: Resultsmentioning

confidence: 99%

Teleconsultation and Clinical Decision Making: a Systematic Review

2016

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Background:The goal of teleconsultation is to omit geographical and functional distance between two or more geographically separated health care providers. The purpose of present study is to review and analyze physician-physician teleconsultations. Method: The PubMed electronic database was searched. The primary search was done on January 2015 and was updated on December 2015. A fetch and tag plan was designed by the researchers using an online Zotero library. Results: 174 full-text articles of 1702 records met inclusion criteria. Teleconsultation for pediatric patients accounts for 14.36 percent of accepted articles. Surgery and general medicine were the most prevalent medical fields in the adults and pediatrics, respectively. Most teleconsultations were inland experiences (no=135), and the USA, Italy and Australia were the three top countries in this group. Non-specialists health care providers/centers were the dominant group who requested teleconsultation (no=130). Real time, store and forward, and hybrid technologies were used in 50, 31, and 16.7 percent of articles, respectively. The teleconsultation were reported to result in change in treatment plan, referral or evacuation rate, change in diagnosis, educational effects, and rapid decision making. Use of structured or semi-structured template had been noticed only in a very few articles. Conclusion: The present study focused on the recent ten years of published articles on physician-physician teleconsultations. Our findings showed that although there are positive impacts of teleconsultation as improving patient management, still have gaps that need to be repaired.

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Section: Resultsmentioning

confidence: 99%

Teleconsultation and Clinical Decision Making: a Systematic Review

2016

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“…For example, prior research found that women were more likely than men to shelter in place due to concerns about the risk of COVID-19 infection for themselves and their family; this would make virtual visits a more appealing visit type for women [25]. Additionally, studies prior to the pandemic demonstrated that women used virtual visits more often than men [11]. Similarly, patients with Medicare insurance may have been more concerned about acquiring COVID-19 infection and prefer to shelter in place, leading to their increased likelihood of attending a virtual visit.…”

Section: Principal Findingsmentioning

confidence: 99%

“…Additionally, adults who are older, men, and Black have been shown to have lower health literacy levels than those who are younger, women, and White; and low health literacy is associated with a greater likelihood of needing help performing online tasks [8][9][10]. These disparities in access to the internet and devices and lower health literacy levels may lead to corresponding disparities in health care delivery and quality, particularly if the quality of health care visits and visit satisfaction are greater with video visits compared to telephone visits [11][12][13]. Furthermore, patients who opted out of virtual visits entirely and continued to attend in-person visits during the pandemic may have increased their risk of exposure to COVID-19 or experienced decreased appointment availability due to the decrease in in-person capacity required to maintain COVID-19 social distancing.…”

Section: Introductionmentioning

confidence: 99%

Growth of Ambulatory Virtual Visits and Differential Use by Patient Sociodemographics at One Urban Academic Medical Center During the COVID-19 Pandemic: Retrospective Analysis

Gilson¹,

Umscheid²,

Laiteerapong³

et al. 2020

JMIR Med Inform

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Background Despite widespread interest in the use of virtual (ie, telephone and video) visits for ambulatory patient care during the COVID-19 pandemic, studies examining their adoption during the pandemic by race, sex, age, or insurance are lacking. Moreover, there have been limited evaluations to date of the impact of these sociodemographic factors on the use of telephone versus video visits. Such assessments are crucial to identify, understand, and address differences in care delivery across patient populations, particularly those that could affect access to or quality of care. Objective The aim of this study was to examine changes in ambulatory visit volume and type (ie, in-person vs virtual and telephone vs video visits) by patient sociodemographics during the COVID-19 pandemic at one urban academic medical center. Methods We compared volumes and patient sociodemographics (age, sex, race, insurance) for visits during the first 11 weeks following the COVID-19 national emergency declaration (March 15 to May 31, 2020) to visits in the corresponding weeks in 2019. Additionally, for visits during the COVID-19 study period, we examined differences in visit type (ie, in-person versus virtual, and telephone versus video visits) by sociodemographics using multivariate logistic regression. Results Total visit volumes in the COVID-19 study period comprised 51.4% of the corresponding weeks in 2019 (n=80,081 vs n=155,884 visits). Although patient sociodemographics between the COVID-19 study period in 2020 and the corresponding weeks in 2019 were similar, 60.5% (n=48,475) of the visits were virtual, compared to 0% in 2019. Of the virtual visits, 61.2% (n=29,661) were video based, and 38.8% (n=18,814) were telephone based. In the COVID-19 study period, virtual (vs in-person) visits were more likely among patients with race categorized as other (vs White) and patients with Medicare (vs commercial) insurance and less likely for men, patients aged 0-17 years, 65-74 years, or ≥75 years (compared to patients aged 18-45 years), and patients with Medicaid insurance or insurance categorized as other. Among virtual visits, compared to telephone visits, video visits were more likely to be adopted by patients aged 0-17 years (vs 18-45 years), but less likely for all other age groups, men, Black (vs White) patients, and patients with Medicare or Medicaid (vs commercial) insurance. Conclusions Virtual visits comprised the majority of ambulatory visits during the COVID-19 study period, of which a majority were by video. Sociodemographic differences existed in the use of virtual versus in-person and video versus telephone visits. To ensure equitable care delivery, we present five policy recommendations to inform the further development of virtual visit programs and their reimbursement.

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“…This suggests that video consultation used in the correct circumstances could potentially be a more effective consulting tool than mobile consultations used in current practice. Similar results were found in Germany within an acute healthcare setting (Handschu et al ., 2008).…”

Section: Introductionmentioning

confidence: 99%