The Time Is Now: A Guide to Sustainable Telemedicine During COVID-19 and Beyond

Shah, Eric D.; Amann, Stephen T.; Karlitz, Jordan J.

doi:10.14309/ajg.0000000000000767

Cited by 30 publications

(31 citation statements)

References 8 publications

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“…However, the SARS-CoV-2 pandemic forced rapid changes and adjustments on the entire medical system, and long distance patient surveillance when applicable became a major need. Practical guidelines to telemedicine usage were published, 11 and both patients and physicians became more aware and willing to experience this communication method. Herein, we describe patients’ perception and acceptance of this new technology for regular clinic visits.…”

Section: Discussionmentioning

confidence: 99%

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Telemedicine in clinical gastroenterology practice: what do patients prefer?

Lahat

Shatz

2021

Therap Adv Gastroenterol

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Background: The Coronavirus Disease 2019 pandemic has forced major changes on healthcare systems. Maintaining regular patients’ surveillance became a major challenge. Telemedicine has been promoted as an economic and effective way for long distance patient care. Our aim was to study patients’ acceptance and perspectives on telemedicine. Methods: Patients scheduled for clinic appointments were offered telemedicine. Those who agreed were asked to fill in a questionnaire assessing their satisfaction with the medical consultation. Patients’ demographic characteristics and answers were collected and reviewed. Results: Out of 358 patients approached 71 agreed to use telemedicine. Of them, 59 completed the questionnaire and were included in the study. All patients’ basic demographic data were collected. Patients’ included in the study mean age was: 43 ± 16.3 years, 35 (59.3%) women. Patients who chose not to use telemedicine were significantly older, mean age: 61 ± 15.2 years ( p = 0.036), 134 (46.7%) women. Most patients included (38; 64.4%) had inflammatory bowel disease (IBD). Most patients who chose not to use telemedicine were non-IBD patients (206, 72%). Fifty-one patients (86.4%) assessed their experience as ‘good’ or ‘excellent’. Satisfied patients had significantly less time under medical follow-up (3.7 versus 6.1 years, p = 0.028) and tended to be younger ( p = non-significant). Women were statistically significantly more satisfied than men (33 versus 18, p = 0.05). Advantages reported were ‘time saving’ (31.3%), accessibility (26.1%), availability (25%). The main disadvantage was absence of physical examination (70%). Conclusions: Telemedicine gained a high satisfaction rate among patients under regular medical surveillance. Most patients stated this that method is convenient, time saving and increases their compliance. Patients who agreed to telecare were younger, and tended to be of female gender and experiencing IBD. Further studies are needed to characterize specific barriers to telecare usage.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, our results correlate with data in the literature showing that telemedicine is especially useful to patients with chronic gastrointestinal disease who require regular and frequent visits. 11 , 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

Telemedicine in clinical gastroenterology practice: what do patients prefer?

Lahat

Shatz

2021

Therap Adv Gastroenterol

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“…Regardless of the type of inpatient telemedicine visit, a stable and high-speed Internet connection combined with sensors to measure vital signs and other physical examination aspects is required [ 18 ]. Active communication with the referring team can be reimbursed as complex in-person consultations [ 16 ].…”

Section: Inpatient Gi Referrals During Covid-19mentioning

confidence: 99%

“…Provider factors— Similar to patient factors, providers are familiar with the paradigm of F2F visits, often relying on non-verbal cues to connect with their patients [ 16 ], while keeping the patient-provider relationship intact by engaging the patient and the family members accompanying them. A survey of GI providers in April 2020 showed that 68% of respondents never performed video consultations prior to the pandemic [ 41 ].…”

Section: Barriers To Telemedicinementioning

confidence: 99%

“…Nonetheless, CMS expanded telemedicine benefits on an emergency and temporary basis (1135 waiver authority and Coronavirus Preparedness Response Supplemental Appropriations Act, March 27, 2020 [H.R.6074]) so as to remove the restriction of location (patients can receive care from home and at any facility) with CDC recommendations to limit in-person visits [ 15 ]. These changes, adopted by private insurers as well [ 16 ], were rapidly adopted by hospitals and healthcare institutions in order to incorporate telemedicine into GI practice in both outpatient and inpatient settings. Due to these changes, multiple studies were published in order to evaluate the efficacy, outcomes of telemedicine in GI diseases extending well beyond IBD and HCV management.…”

Section: Introductionmentioning

confidence: 99%

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Successful Distancing: Telemedicine in Gastroenterology and Hepatology During the COVID-19 Pandemic

Perisetti

Goyal

2021

Dig Dis Sci

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Telemedicine involves delivering healthcare and preventative care services to patients without the need for in-person encounters. Traditionally, telemedicine has been used for acute events (e.g., stroke, used to relay essential information to the emergency department) and chronic disease management (e.g., diabetes and chronic kidney disease management). Though the utilization of telemedicine in gastroenterology and hepatology has been modest at best, especially for inflammatory bowel diseases and chronic liver disease management, since the onset of coronavirus disease 2019 (COVID-19) pandemic, utilization of telemedicine in gastroenterology increased by 4000% in the first two weeks, equivalent to the last six years of growth before the pandemic. The Center for Medicare and Medicaid (CMS) relaxed rules for the use of telemedicine with easing restrictions on reimbursements, location, licensing requirements (across state lines), and the need for a prior provider-patient relationship. These changes increased the use of telemedicine in inpatient and outpatient settings for gastroenterology-related referrals. The use of inpatient telephonic or video consults helps provide timely care during the pandemic while conserving personal protective equipment and decreasing provider and patient exposure. Nevertheless, telehealth use comes at the cost of no direct patient contact and lesser reimbursements. The appropriate use of technology and equipment, training of healthcare providers, use of platforms that can be integrated into the electronic health record while protecting the privacy and the flow of information are essential components of telemedicine. Furthermore, encouraging patients to seek medical care remotely with the proper equipment and improving digital literacy without the need for physical examinations is a challenge, further compounded in elderly or hard-of-hearing patients and in patients who are more comfortable with in-person visits. The authors will systematically review and discuss how telemedicine can be integrated into the practice of gastroenterology and hepatology, with emphasis placed on discussing barriers to success and the ways they can be mitigated.

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Home‐Based Telemedicine in Rheumatology—A Scoping Review

Venuturupalli,

Peck,

Jinka

et al. 2024

ACR Open Rheumatology

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ObjectiveWe performed a scoping review of the relevant literature on home‐based telehealth in rheumatology to understand its appropriate application in rheumatology practice.MethodsWe searched the Cochrane Library, PubMed, Web of Science, and scientific meeting abstracts to identify articles that specifically addressed telehealth suitability, barriers to telehealth, patient‐reported outcomes (PROs) collected in telehealth settings, and telehealth satisfaction. From the initial search of 4,882 studies, 23 reports were included. In addition, 10 abstracts were also eligible for analysis, resulting in a total of 33 articles: 2 randomized clinical trials, 9 prospective cohort studies, and 22 retrospective studies.ResultsWe found that triage appointments or predictive models could be helpful in selecting patients for telehealth and that telehealth interventions were appropriate for follow‐up of patients with systemic lupus erythematosus and inflammatory arthritis, but that conducting new patient visits over telehealth was not ideal. Barriers to telehealth include patient factors (age, technology access) and need for physician/process factors (eg, physical examinations). PROs collected in regular practice can be incorporated into telehealth. Several small, single‐center studies suggest that telehealth does not lead to negative outcomes compared with in‐person visits, and overall, patients report high patient satisfaction with telehealth. In several scenarios, home‐based telehealth was equivalent to in‐person visits with regard to patient outcomes and satisfaction.ConclusionThe widespread potential of telehealth to manage and deliver care for people with rheumatic disease is significant. As such, further research in the form of randomized controlled trials can help contribute to growing evidence that shapes telehealth implementation for patients with rheumatic diseases.

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The Time Is Now: A Guide to Sustainable Telemedicine During COVID-19 and Beyond

Cited by 30 publications

References 8 publications

Telemedicine in clinical gastroenterology practice: what do patients prefer?

Telemedicine in clinical gastroenterology practice: what do patients prefer?

Successful Distancing: Telemedicine in Gastroenterology and Hepatology During the COVID-19 Pandemic

Home‐Based Telemedicine in Rheumatology—A Scoping Review

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