Implementation Guide for Rapid Integration of an Outpatient Telemedicine Program During the COVID-19 Pandemic

Smith, Whitney R.; Atala, Anthony; Terlecki, Ryan; Kelly, Erin E.; Matthews, Catherine A.

doi:10.1016/j.jamcollsurg.2020.04.030

Cited by 172 publications

(176 citation statements)

References 14 publications

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“…For the integration of telemedicine in healthcare technological and legal aspects are necessary [ 4 ]. Our institutional platform provided the technological aspects with videoconference support, electronic medical record, online prescribing options, laboratory results, imaging, and pathology reports.…”

Section: Discussionmentioning

confidence: 99%

“…Recent coronavirus outbreak [ 3 ] has accelerated the implementation of virtual health platforms and pushed its limits to the edge. “Stay at home” policies such as lockdowns, curfews and social distancing protocols have forced patients to stay away from hospitals and postpone surgical consultations [ 2 , 4 ]. Telemedicine has been reported useful in preoperative and postoperative surgical consultations and has even been used for intraoperative mentoring with successful outcomes for patients [ 5 ].…”

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confidence: 99%

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Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

et al. 2020

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Summary and background data Recent coronavirus outbreak and “stay at home” policies have accelerated the implementation of virtual healthcare. Many surgery departments are implementing telemedicine to enhance remote perioperative care. However, concern still arises regarding the safety of this modality in postoperative follow-up after gastrointestinal surgery. The aim of the present prospective study is to compare the use of telemedicine clinics to in-person follow-up for postoperative care after gastrointestinal surgery during COVID-19 outbreak. Methods Prospective study that included all abdominal surgery patients operated since the COVID-19 outbreak. On discharge, patients were given the option to perform their postoperative follow-up appointment by telemedicine or by in-person clinics. Demographic, perioperative, and follow-up variables were analyzed. Results Among 219 patients who underwent abdominal surgery, 106 (48%) had their postoperative follow-up using telemedicine. There were no differences in age, gender, ASA score, and COVID-19 positive rate between groups. Patients who preferred telemedicine over in-person follow-up were more likely to have undergone laparoscopic surgery (71% vs. 51%, P = 0.037) and emergency surgery (55% vs. 41%; P = 0.038). Morbidity rate for telemedicine and in-person group was 5.7% and 8%, ( P = 0.50). Only 2.8% of patients needed an in-person visit following the telemedicine consult, and 1.9% visited the emergency department. Conclusions In the current pandemic, telemedicine follow-up can be safely and effectively performed in selected surgical patients. Patients who underwent laparoscopic and emergency procedures opted more for telemedicine than in-person follow-up.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

et al. 2020

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“…Before this pandemic, video consultations were mainly used with patients who had problems accessing the healthcare services [18], for medical consultations in primary and hospital care [19,20], and for chronic disease conditions [21][22][23]. In addition, video consultations were also used for communication between healthcare professionals and clinicians [24].…”

Section: Introductionmentioning

confidence: 99%

Simulated Video Consultations as a Learning Tool in Undergraduate Nursing: Students’ Perceptions

Jiménez-Rodríguez

Arrogante

2020

Healthcare

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Simulated video consultations, a teaching tool based on high-fidelity simulations, were implemented in response to the necessary adaptation of high-fidelity clinical simulation sessions to the online or virtual modality during the university closure due to the COVID-19 confinement. The purpose of our study was to explore the undergraduate nursing students’ satisfaction and perceptions about simulated video consultations using the high-fidelity simulation methodology. A mixed-method was utilized with 93 undergraduate nursing students using a validated satisfaction questionnaire (quantitative data), which included an observations section (qualitative data). Of the total sample, 97.8% of the students expressed a high overall satisfaction with simulated video consultations, highlighting their practical utility and positive learning outcomes. From the students’ comments, two main themes and their related categories emerged: advantages (satisfaction and enjoyment, learning, and calmness during simulated scenarios), and disadvantages (technical issues and technical skills development). Simulated video consultations may be considered as one more high-fidelity simulation teaching option. Nursing students should be trained in this modality of healthcare to face the challenge brought on by its increased use in healthcare services, beyond the specific adaptation of clinical simulation sessions due to the closure of universities during this pandemic.

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“…After initial organizational problems, hospitals were divided into sections devoted to COVID-19 patients only. Admissions to hospitals were decreased, thereby avoiding non-urgent conditions and deferrable elective operations 5 , 6 , 7 . Our activity as vascular surgeons had been reduced dramatically, and were assigned to perform other duties in the pneumology departments and emergency departments for COVID-19 positive patients, in addition to our consultancy activities.…”

Section: Methodsmentioning

confidence: 99%

Acute arterial and deep venous thromboembolism in COVID-19 patients: Risk factors and personalized therapy

Bozzani

Arici

Tavazzi

et al. 2020

Surgery

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Introduction The Lombardy region (Italy) suffered severe problems during the acute phase of the outbreak of COVID-19 in Italy (March-April 2020) with 16,000 diagnosed COVID-19 related deaths (49% of the total COVID-19 related deaths in Italy). In the area surrounding Pavia during the critical stage of the outbreak (March-April), 1,225 of the documented 4,200 deaths were related to COVID-19 infection, with a mortality rate of 181/100,000 inhabitants and an increase in deaths of 138% compared to the same period in previous years. Aim Our aim was to report the experience of the Department of Vascular Surgery of Pavia (Lombardy), including the lessons learned and future perspectives regarding the management of COVID-19 patients who developed severe acute ischemia with impending lower limb loss or deep vein thrombosis (DVT). Materials and Methods We carried out a retrospective data collection of COVID-19 patients with severe acute ischemia of the lower limbs or DVT observed in our Department during the period March 1 st to April 30 th 2020. Primary outcomes of the analysis were postoperative mortality for all patients and amputation rates only in those COVID-19 patients suffering from acute lower limb ischemia. Secondary outcomes were the prevalence of the disease among admitted COVID-19 patients, and any possible correlation between inflammatory parameters, thrombolytic status, and the presence of acute ischemia or DVT. Results We observed 38 patients (28 male) with severe COVID-19 infection (6 with lower limb arterial thrombosis and 32 with DVT). The median age was 64 years (range 30-94 years). In the arterial group, 3 had thrombosis on plaque and 3 on healthy arteries ("simple" arterial thrombosis). All underwent operative or hybrid (open/endo) revascularization; 1 patient died from major organ failure (MOF) and one patient underwent major amputation. In the DVT group, 9 (28%) patients died from MOF, despite aggressive medical therapy. In patients with "simple" arterial thrombosis and those with DVT, we observed a decrease in inflammatory parameters (CRP) and in D-dimer and fibrinogen after aggressive therapy (p <0.001). Conclusions Our study confirms that critically ill, COVID-19 patients who develop arterial and deep vein thrombosis are at high risk of mortality, but if treated properly, there is an improvement in overall survival rate, especially in patients of 60 years of age or younger.

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Implementation Guide for Rapid Integration of an Outpatient Telemedicine Program During the COVID-19 Pandemic

Cited by 172 publications

References 14 publications

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic

Simulated Video Consultations as a Learning Tool in Undergraduate Nursing: Students’ Perceptions

Acute arterial and deep venous thromboembolism in COVID-19 patients: Risk factors and personalized therapy

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