Conducting remote medical asylum evaluations in the United States during COVID-19: Clinicians’ perspectives on acceptability, challenges and opportunities

Abstract

Background Due to the COVID-19 pandemic, medical evaluations for asylum are being performed predominantly remotely. We sought to describe these evaluations and identify barriers. Methodology This study utilized an online survey to assess clinician perspectives and experiences regarding remote asylum evaluations. Results Clinicians reported positive experiences regarding remote interpretation (85%, 51/60), history taking (82.4%, 61/74), rapport building (81.3%, 61/75), and conducting the psychiatric exam (65.7%, 44/67). Concerns were more frequently reported with performing remote physical examinations (83.3%, 15/18). Although the majority denied challenges with technology (62.5%, 45/72), internet (60.8%, 45/74) or clients having difficulty acquiring technology (58.6%, 41/70) or finding private spaces (54.2%, 39/72), these aspects did represent barriers. Discussion Remote evaluations were relatively easy to perform and acceptable to clinicians. This may facilitate easier access for asylum seekers beyond the pandemic.

Exploratory study on the quality of forensic assessments using the Istanbul Protocol in a virtual versus face-to-face environment.

“…In virtual IP interviews, difficulties are observed in the lack of material resources (inadequate equipment, Internet connection, and suitable places in the survivor's environment to conduct the interviews). Consistent with previous similar studies (Pogue et al, 2021), these difficulties affect the time of the process, involving more sessions than in face-to-face cases. In addition, due to the difficulties that the virtual format generates in the understanding of non-verbal communication, in a few cases problems have been detected in collecting information and establishing the transference bond with the examinee, where specific difficulties might appear in terms of warmth, empathy, and rapport in the process.…”

“…The Covid-19 pandemic has affected models of care and forensic assessment of asylum seekers, which, after initially stalling, have shifted significantly to remote formats com-patible with the total or partial lockdown. Different studies have reported on these changes either in assessments conducted by telephone (Cohen et al, 2021), by video call (Mishori et al, 2021), or using a combination of both methodologies (Green et al, 2020;Pogue et al, 2021). While these studies have generally supported the use of remote assessments alone (Greenhalgh et al, 2020;Pogue et al, 2021), others have recommended a hybrid approach (Gruber et al, 2021).…”

“…Different studies have reported on these changes either in assessments conducted by telephone (Cohen et al, 2021), by video call (Mishori et al, 2021), or using a combination of both methodologies (Green et al, 2020;Pogue et al, 2021). While these studies have generally supported the use of remote assessments alone (Greenhalgh et al, 2020;Pogue et al, 2021), others have recommended a hybrid approach (Gruber et al, 2021). However, such assessments are not without problems, such as the lack of material means, resources to carry them out, problems related to rapport building (Mishori et al, 2021), and transference and psychotherapeutic aspects.…”

Visual Object Detection with DETR to Support Video-Diagnosis Using Conference Tools

“…Nowadays, the importance of multilingual translation has grown exponentially thanks to the impact of the COVID-19 pandemic [1,2]. Visual Object Detection [3,4] (moreover, Textual Object Detection), as a central topic of video conference-based remote diagnosis and consultancy [5] has intensified the digital transformation in the medical field.…”

“…The issue generates a new 'realtime multilingual data processing' market to catalyze the elimination of existing communication barriers of multilingual video conferences. The adoption of Visual Object Detection (VOD) to the healthcare domain will increase the efficacy of remote diagnosis processes [2], reducing the reaction time in remote consultations. Furthermore, optical character recognition (OCR) is becoming more popular [6], since it is considered a central pillar of many advanced technologies, particularly related to real-time object detection.…”