How telemedicine integrated into China’s anti-COVID-19 strategies: case from a National Referral Center

Li, Peiyi; Liu, Xiaoyu; Mason, Elizabeth; Hu, Guangyu; Zhou, Yubin; Liu, Weimin; Jalali, Mohammad S.

doi:10.1136/bmjhci-2020-100164

Cited by 42 publications

(44 citation statements)

References 18 publications

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“…According to these results, greater proportions of adults younger than 56 years have engaged in and are interested in telehealth than those 56 years or older, which may be unsurprising given the reported digital divide between younger and older generations [ 18 ]. This phenomenon has also been reflected in other literature assessing telehealth use both prior to and during the pandemic [ 19 - 21 ]. Although a higher percentage of older adults expressed no interest in telehealth compared to younger age groups, nearly half of those 56 years or older started using telehealth in response to COVID-19, nearly half said they would be willing to participate in telehealth even though they wanted to return to in person in the future, one-third wanted to participate in telehealth even after the pandemic, and only 5% reported being interested but not knowing how to use telehealth.…”

Section: Discussionsupporting

confidence: 58%

Telemedicine Use and Health-Related Concerns of Patients With Chronic Conditions During COVID-19: Survey of Members of Online Health Communities

Horrell¹,

Hayes²,

Herbert³

et al. 2021

J Med Internet Res

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Background It has been widely communicated that individuals with underlying health conditions are at higher risk of severe disease due to COVID-19 than healthy peers. As social distancing measures continue during the COVID-19 pandemic, experts encourage individuals with underlying conditions to engage in telehealth appointments to maintain continuity of care while minimizing risk exposure. To date, however, little information has been provided regarding telehealth uptake among this high-risk population. Objective The aim of this study is to describe the telehealth use, resource needs, and information sources of individuals with chronic conditions during the COVID-19 pandemic. Secondary objectives include exploring differences in telehealth use by sociodemographic characteristics. Methods Data for this study were collected through an electronic survey distributed between May 12-14, 2020, to members of 26 online health communities for individuals with chronic disease. Descriptive statistics were run to explore telehealth use, support needs, and information sources, and z tests were run to assess differences in sociodemographic factors and information and support needs among those who did and did not use telehealth services. Results Among the 2210 respondents, 1073 (49%) reported engaging in telehealth in the past 4 months. Higher proportions of women engaged in telehealth than men (890/1781, 50% vs 181/424, 43%; P=.007), and a higher proportion of those earning household incomes of more than US $100,000 engaged in telehealth than those earning less than US $30,000 (195/370, 53% vs 241/530 45%; P=.003). Although 59% (133/244) of those younger than 40 years and 54% (263/486) of those aged 40-55 years used telehealth, aging populations were less likely to do so, with only 45% (677/1500) of individuals 56 years or older reporting telehealth use (P<.001 and P=.001, respectively). Patients with cystic fibrosis, lupus, and ankylosing spondylitis recorded the highest proportions of individuals using telehealth when compared to those with other diagnoses. Of the 2210 participants, 1333 (60%) participants either looked up information about the virus online or planned to in the future, and when asked what information or support would be most helpful right now, over half (1151/2210, 52%) responded “understanding how COVID-19 affects people with my health condition.” Conclusions Nearly half of the study sample reported participating in telehealth in the past 4 months. Future efforts to engage individuals with underlying medical conditions in telehealth should focus on outreach to men, members of lower-income households, and aging populations. These results may help inform and refine future health communications to further engage this at-risk population in telehealth as the pandemic continues.

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Section: Discussionsupporting

confidence: 58%

Telemedicine Use and Health-Related Concerns of Patients With Chronic Conditions During COVID-19: Survey of Members of Online Health Communities

Horrell¹,

Hayes²,

Herbert³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

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“…Also, there was likely a conversion of many in-person visits to telehealth visits and consultations [39] , [40] , [41] , [42] , [43] . Due to the quarantine and social distancing need, there has been a surge in the use of telehealth and virtual care services provided by traditional health facilities or through the platforms of technology companies in China during the pandemic, which has been widely reported [43] , [44] , [45] , [46] . Second, the drop of income and employer-based health insurance coverage due to furlough or loss of job further raised the barriers to accessing healthcare services [47] , [48] , [49] .…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on health services utilization in China: Time-series analyses for 2016–2020

Xiao

Dai

Wagenaar

et al. 2021

The Lancet Regional Health - Western Pacific

124

134

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Background The aim of this study is to quantify the effects of the SARS-CoV-2 pandemic on health services utilization in China using over four years of routine health information system data. Methods We conducted a retrospective observational cohort study of health services utilization from health facilities at all levels in all provinces of mainland China. We analyzed monthly all-cause health facility visits and inpatient volume in health facilities before and during the SARS-CoV-2 outbreak using nationwide routine health information system data from January 2016 to June 2020. We used interrupted time series analyses and segmented negative binomial regression to examine changes in healthcare utilization attributable to the pandemic. Stratified analyses by facility type and by provincial Human Development Index (HDI) – an area-level measure of socioeconomic status – were conducted to assess potential heterogeneity in effects. Findings In the months before the SARS-CoV-2 outbreak, a positive secular trend in patterns of healthcare utilization was observed. After the SARS-CoV-2 outbreak, we noted statistically significant decreases in all indicators, with all indicators achieving their nadir in February 2020. The magnitude of decline in February ranged from 63% (95% CI 61–65%; p <0•0001) in all-cause visits at hospitals in regions with high HDI and 71% (95% CI 70–72%; p <0•0001) in all-cause visits at primary care clinics to 33% (95% CI 24–42%; p <0•0001) in inpatient volume and 10% (95% CI 3–17%; p = 0•0076) in all-cause visits at township health centers (THC) in regions with low HDI. The reduction in health facility visits was greater than that in the number of outpatients discharged (51% versus 48%; p <0•0079). The reductions in both health facility visits and inpatient volume were greater in hospitals than in primary health care facilities ( p <0•0001) and greater in developed regions than in underdeveloped regions ( p <0•0001). Following the nadir of health services utilization in February 2020, all indicators showed statistically significant increases. However, even by June 2020, nearly all indicators except outpatient and inpatient volume in regions with low HDI and inpatient volume in private hospitals had not achieved their pre-SARS-COV-2 forecasted levels. In total, we estimated cumulative losses of 1020.5 (95% CI 951.2- 1089.4; P <0.0001) million or 23.9% (95% CI 22.5–25.2%; P <0.0001) health facility visits, and 28.9 (95% CI 26.1–31.6; P <0.0001) million or 21.6% (95% CI 19.7–23.4%; P <0.0001) inpatients as of June 2020. Interpretation Inpatient and outpatient health services utilization in China declined sig...

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“…Telehealth systems can significantly improve the triage, treatment, and care of patients, particularly where there is a restriction of the available resources ( 8 ). The use of telehealth is one of the services that should be offered by healthcare providers to continue patient care while minimizing the risk of exposure to or transmission of COVID-19 ( 13 ). In China, areas with poor access to healthcare services reported a higher case fatality rate of COVID-19 than those with sufficient access to healthcare services ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Telehealth-Based Services During the COVID-19 Pandemic: A Systematic Review of Features and Challenges

Khoshrounejad

Hamednia

Mehrjerd

et al. 2021

Front. Public Health

115

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Background: As an ever-growing popular service, telehealth catered for better access to high-quality healthcare services. It is more valuable and cost-effective, particularly in the middle of the current COVID-19 pandemic. Accordingly, this study aimed to systematically review the features and challenges of telehealth-based services developed to support COVID-19 patients and healthcare providers.Methods: A comprehensive search was done for the English language and peer-reviewed articles published until November 2020 using PubMed and Scopus electronic databases. In this review paper, only studies focusing on the telehealth-based service to support COVID-19 patients and healthcare providers were included. The first author's name, publication year, country of the research, study objectives, outcomes, function type including screening, triage, prevention, diagnosis, treatment or follow-up, target population, media, communication type, guideline-based design, main findings, and challenges were extracted, classified, and tabulated.Results: Of the 5,005 studies identified initially, 64 met the eligibility criteria. The studies came from 18 countries. Most of them were conducted in the United States and China. Phone calls, mobile applications, videoconferencing or video calls, emails, websites, text messages, mixed-reality, and teleradiology software were used as the media for communication. The majority of studies used a synchronous communication. The articles addressed the prevention, screening, triage, diagnosis, treatment, and follow-up aspects of COVID-19 which the most common purpose was the patients' follow-up (34/64, 53%). Thirteen group barriers were identified in the literature, which technology acceptance and user adoption, concerns about the adequacy and accuracy of subjective patient assessment, and technical issues were the most frequent ones.Conclusion: This review revealed the usefulness of telehealth-based services during the COVID-19 outbreak and beyond. The features and challenges identified through the literature can be helpful for a better understanding of current telehealth approaches and pointed out the need for clear guidelines, scientific evidence, and innovative policies to implement successful telehealth projects.

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How telemedicine integrated into China’s anti-COVID-19 strategies: case from a National Referral Center

Cited by 42 publications

References 18 publications

Telemedicine Use and Health-Related Concerns of Patients With Chronic Conditions During COVID-19: Survey of Members of Online Health Communities

Telemedicine Use and Health-Related Concerns of Patients With Chronic Conditions During COVID-19: Survey of Members of Online Health Communities

The impact of the COVID-19 pandemic on health services utilization in China: Time-series analyses for 2016–2020

Telehealth-Based Services During the COVID-19 Pandemic: A Systematic Review of Features and Challenges

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