Accelerated launch of video visits in ambulatory neurology during COVID-19

Yang, Laurice; Brown‐Johnson, Cati; Miller-Kuhlmann, Rebecca; Kling, Samantha M.R.; Saliba‐Gustafsson, Erika A.; Shaw, Jonathan G.; Gold, Carl A.; Winget, Marcy

doi:10.1212/wnl.0000000000010015

Cited by 29 publications

(67 citation statements)

References 29 publications

(37 reference statements)

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“…Throughout the international medical community, healthcare leaders have described their experiences and recommendations as we adapt to meet the demands of this crisis. 9,[16][17][18][19][20][21][22] As we are slowly transitioning to the next phase of medical care in this Covid-19 era, we remain highly cognizant that a similar crisis may recur at any point. Our department has, therefore, elected to continue many of the changes already instituted for the foreseeable future.…”

Section: Resultsmentioning

confidence: 99%

Folding a neuroscience center into streamlined COVID-19 response teams

et al. 2020

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In response to the Covid-19 pandemic epicenter in Bronx NY, our Neuroscience center required rapid and drastic changes when considering the delivery of neurologic care, health and safety of staff, and continued education and safety for house-staff. In healthcare, we rely on principles that can be in conflict during a disaster response such as this pandemic, with equal commitments to ensure the best care for those stricken with Covid-19, provide high quality care and advocacy for patients and families coping with neurologic disease, and advocate for the health and safety of healthcare teams, particularly house-staff and colleagues who are most vulnerable. In our attempt to balance these principles, over three weeks, we reformatted our inpatient neuroscience services by reducing from four wards to just one, still delivering care to over 600 hospitalized neuro-covid patients and over 1742 total neuroscience hospital bed days. This description from members of our leadership team provides an on-the-ground account of our effort to respond nimbly to a complex and evolving surge of Covid patients in a large urban hospital network. Our efforts were based on (1) strategies to mitigate exposure and transmission, (2) protection of the health and safety of staff, (3) alleviation of logistical delays and strains in the system, and (4) facilitating coordinated communication. Each center’s experience will add to knowledge of best practices and emerging research will help us with insights toward an evidence-based approach to neurologic care during and after the Covid-19 pandemic.

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Section: Resultsmentioning

confidence: 99%

Folding a neuroscience center into streamlined COVID-19 response teams

et al. 2020

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“…It was conducted at Stanford University's Department of Neurology and Neurological Sciences, which includes 11 ambulatory subspecialties staffed by 60 physicians and 8 advanced practice providers (APPs). As previously described [27], at the beginning of the local COVID-19 stay-at-home directive in March 2020, approximately 50 in-clinic computers were video visit-enabled, and 50 additional computer devices were readied for remote use by providers. Clinic staff converted >90% of scheduled in-person visits to video.…”

Section: Settingmentioning

confidence: 99%

“…To further support this pivot and maintain health care access, the United States loosened previously stringent federal regulations on reimbursements, licensing, and Health Insurance Portability and Accountability Act (HIPAA) compliance [22,23]. In neurology specifically, the urgent need to provide care safely to patients with chronic illnesses while preventing disease transmission during clinic visits, led to rapid implementation of video visits across all subspecialties [24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Rapid Implementation of Video Visits in Neurology During COVID-19: Mixed Methods Evaluation (Preprint)

Saliba‐Gustafsson¹,

Miller-Kuhlmann²,

Kling³

et al. 2020

Preprint

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BACKGROUND Telemedicine has been used for decades; yet, despite its many advantages, its uptake and rigorous evaluation of feasibility across neurology’s ambulatory subspecialties has been sparse. The SARS-CoV-2 (COVID-19) pandemic however, prompted healthcare systems worldwide to reconsider traditional healthcare delivery. To safeguard healthcare workers and patients many healthcare systems quickly transitioned to telemedicine, including across neurology subspecialties, providing a new opportunity to evaluate this modality of care. OBJECTIVE To evaluate the accelerated implementation of video visits in ambulatory neurology during the COVID-19 pandemic, we used mixed methods to assess the adoption, acceptability, appropriateness, and perceptions of potential sustainability. METHODS Video visits were launched rapidly in ambulatory neurology clinics of a large academic medical center. To assess adoption, we analyzed clinician-level scheduling data collected between March 22 and May 16, 2020. We assessed acceptability, appropriateness, and sustainability via a clinician survey (n=48) and semi-structured interviews with providers (n=30) completed between March and May 2020. RESULTS Video visits were adopted rapidly; 65 (98%) clinicians integrated video visits into their workflow within the first 6 implementation weeks and 92% of all visits were conducted via video. Video visits were largely considered acceptable by clinicians, although various technological issues impacted satisfaction. Video visits were reported to be more convenient for patients, families, and/or caregivers than in-person visits; however, access to technology, the patient’s technological capacity, and language difficulties were considered barriers. Many clinicians expressed optimism about future utilization of video visits in neurology. They believed that video visits promote continuity of care and can be incorporated into their practice long-term, although several insisted that they can never replace the in-person examination. CONCLUSIONS Video visits are an important addition to clinical care in ambulatory neurology and are anticipated to remain a permanent supplement to in-person visits, promoting patient care continuity, and flexibility for patients and clinicians alike.

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“…Multiple studies, mostly performed in the adult population, describe overall positive experiences by both patients and providers in telehealth clinics. [12][13][14][15] There are no reports to our knowledge of patient and provider perceptions of telehealth as experienced in a pediatric pulmonary subspecialty clinic.…”

Section: Introductionmentioning

confidence: 99%

Rapid Implementation of Telehealth Services in a Pediatric Pulmonary Clinic During COVID-19

et al. 2021

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This is a prepublication version of an article that has undergone peer review and been accepted for publication but is not the final version of record. This paper may be cited using the DOI and date of access. This paper may contain information that has errors in facts, figures, and statements, and will be corrected in the final published version. The journal is providing an early version of this article to expedite access to this information. The American Academy of Pediatrics, the editors, and authors are not responsible for inaccurate information and data described in this version.

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Accelerated launch of video visits in ambulatory neurology during COVID-19

Cited by 29 publications

References 29 publications

Folding a neuroscience center into streamlined COVID-19 response teams

Folding a neuroscience center into streamlined COVID-19 response teams

Rapid Implementation of Video Visits in Neurology During COVID-19: Mixed Methods Evaluation (Preprint)

Rapid Implementation of Telehealth Services in a Pediatric Pulmonary Clinic During COVID-19

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