The virtual physical exam in the 21st century

Ansary, Ali M; Martinez, Joseph; Scott, John D.

doi:10.1177/1357633x19878330

Cited by 65 publications

(53 citation statements)

References 69 publications

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“…However, new technology such as electronic stethoscopes and smartphone applications that measure patients’ self-palpation are addressing these more intimate aspects of the physical examination. 41 …”

Section: Discussionmentioning

confidence: 99%

“…However, new technology such as electronic stethoscopes and smartphone applications that measure patients' selfpalpation are addressing these more intimate aspects of the physical examination. 41 With technology rapidly advancing, physician shortages increasing, our population ageing and the burden of the current pandemic on our healthcare system, it seems that utilisation of telemedicine may be more important than ever. The benefits of telemedicine are obvious when it comes to social distancing and decreased use of emergency departments, but barriers to telemedicine services including problems with availability and coverage of services contribute to the lack of widespread implementation.…”

Section: Open Accessmentioning

confidence: 99%

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Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA

et al. 2020

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A narrative review was conducted to examine the current state of the utilisation of telemedicine amid the current COVID-19 pandemic and to evaluate the benefits of continuing telemedicine usage in the future. A literature review was performed for articles related to telemedicine. Databases including PubMed, Google Scholar, Cochrane Library and Ovid MEDLINE were searched. Three reviewers independently performed article selection based on relevance to our topic. We included all articles between 1990 and 2020 related to telemedicine using the following keywords: ‘telemedicine’, ‘telehealth’, ‘policy’, ‘COVID-19’, ‘regulation’, ‘rural’, ‘physical examination’, ‘future’. A total of 60 articles were identified, and through careful selection we narrowed the final number of articles to 42 based on relevance to our topic. Telemedicine has been rapidly evolving over the past several decades. Issues with regulation and reimbursement have prevented its full immersion into the healthcare system. During the current pandemic, Centers for Medicare and Medicaid services have expanded access to telemedicine services. The advantages of telemedicine moving forward include its cost-effectiveness, ability to extend access to specialty services and its potential to help mitigate the looming physician shortage. Disadvantages include lack of available technological resources in certain parts of the country, issues with security of patient data, and challenges in performing the traditional patient examination. It is critically important that changes are made to fully immerse telemedicine services into the healthcare landscape in order to be prepared for future pandemics as well as to reap the benefits of this service in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA

et al. 2020

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“…Hence, telepsychiatry was believed to be more feasible, as opposed to other disciplines of medicine. 52 Physical examination is crucial to rule out organicity and examine drug-related adverse effects and comorbid medical symptoms. Some components of physical examination can be directly observed via video, like examining gait disturbances by asking the patient to walk.…”

Section: Strategies To Improve Teleservice: Learnings From the Patienmentioning

confidence: 99%

Patient’s Perspectives of Telepsychiatry: The Past, Present and Future

Naik

Manjunatha

Kumar

et al. 2020

Indian Journal of Psychological Medicine

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Access to mental health care has significant disparities due to treatment gap, more so particularly for the remotely residing, physically vulnerable, aging populations. Adoption of technology will enable more people to receive specialty care addressing distance, transportation and cost-related barriers to treatment engagement from the comfort of home. Telemedicine has been regarded as “electronic personal protective equipment” by reducing the number of physical contacts and risk contamination for patients during COVID-19 crisis. This review aimed to give a broad view of patients’ perception of the use of telepsychiatry in terms of clinical outcome, cost-effectiveness, and solutions to address patients’ challenges with the adoption of technology. Over the years, telepsychiatry, both in synchronous and asynchronous modalities, had shown to improve patients’ adherence to treatment, follow-up rates, and clinical symptoms, overcome stigma and discrimination, and save cost expenses accessing health care with better satisfaction and usability outcomes. Its utility is widespread such as in delivering care emergency evaluation, crisis intervention, conducting neuropsychological assessments, psychotherapy, promoting lifestyle modification, enhancing self-efficacy, and overcoming patients’ linguistic and cultural barriers to care. However, patients’ privacy and confidentiality and psychiatrists’ legal liability remain as matter of major concern in digital platform. To keep up with the pace of technology and patients’ expectations, a more agile approach is essential to develop, improve, and evaluate telepsychiatric interventions.

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“…38 According to a recent study, research regarding the validity of the virtual general physical examination is limited. 39 However, Cottrell and colleagues have demonstrated that a high level of agreement exists between telehealth and in-person assessments for clinical decisions and diagnosis of patients with chronic musculoskeletal conditions and that telehealth may be considered an effective method of assessment. 40 We have found some practical limitations to examination procedures during RTVC.…”

Section: T a G G E D H 1 Applications And Recommendationst A G G E D mentioning

confidence: 99%

Rapid Deployment of Chiropractic Telehealth at 2 Worksite Health Centers in Response to the COVID-19 Pandemic: Observations from the Field

Green

Pence

Kwan

et al. 2020

Journal of Manipulative and Physiological Therapeutics

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Objective: The purpose of this paper is to describe the rapid deployment of telehealth, particularly real time video conference, for chiropractic services as a response to COVID-19. Methods: Two health centers at 2 campuses of a large California corporation have chiropractic care integrated into physical medicine services. Care was suspended beginning on March 17, 2020 to prevent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among patients and staff. On March 19, the Governor of California issued a stay at home order. With musculoskeletal problems being common in the employee patient population, telehealth services were quickly developed to continue chiropractic care for patients. Using existing infrastructure, several members of the health center team developed chiropractic telehealth operations within 2 days. Results: Musculoskeletal telehealth services included examinations, risk assessment, advice, and rehabilitative exercises. These telehealth visits facilitated care that would have otherwise been unavailable to employees. Patients reported that the appointments were helpful, addressed their concerns, and provided a safe method to see their doctor. Regular interprofessional teamwork and relations between the clinic operator and client company were key contributors to operationalizing this service in our integrated healthcare environment. Conclusion: We were able to quickly implement real time video conferencing and other forms of telehealth for chiropractic services at 2 worksite health centers. This paper includes information and insights to providers about setting up similar telehealth systems so they may also provide this benefit for patients in their communities during pandemics or disasters. (J Manipulative Physiol Ther 2020;43;404.e1−404.e10)

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The virtual physical exam in the 21st century

Cited by 65 publications

References 69 publications

Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA

Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA

Patient’s Perspectives of Telepsychiatry: The Past, Present and Future

Rapid Deployment of Chiropractic Telehealth at 2 Worksite Health Centers in Response to the COVID-19 Pandemic: Observations from the Field

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