Practice of Telehealth in Otolaryngology: A Scoping Review in the Era of COVID‐19

Abstract

Objective The COVID-19 pandemic has spurred widespread adoption and advancement in telehealth activities, representing a marked change in otolaryngology practice patterns. The present study undertakes a scoping review of research focused on telehealth in otolaryngology (teleotolaryngology) to identify key themes and commonly utilized outcome measures that will assist future development in this growing field. Data Sources PubMed, Embase, and Cochrane databases and reference review. Review Methods Per guidelines of the PRISMA Extension for Scoping Reviews, we performed database queries using a comprehensive search strategy developed in collaboration with research librarians at the Columbia University Irving Medical Center. We identified 596 unique references to undergo title and abstract review by 2 independent reviewers, leaving 439 studies for full-text review. Results We included 285 studies for extraction of notable findings, leaving 262 unique studies after accounting for content overlap. We identified core outcome measures, including patient and provider satisfaction, costs and benefits, quality of care, feasibility, and access to care. Publication volume increased markedly over time, though only 4% of studies incorporated randomized study group assignment. Using an iterative approach to thematic development, we organized article content across 5 main themes: (1) exploration of teleotolaryngology evolution, (2) role in virtual clinical encounters, (3) applications in interdisciplinary care and educational initiatives, (4) emerging and innovative technologies, and (5) barriers to implementation. Conclusion This scoping review of teleotolaryngology documents its evolution and identifies current use cases, limitations, and emerging applications, providing a foundation from which to build future studies, inform policy decision making, and facilitate implementation where appropriate.

Implementation Strategy for Highly-Coordinated Cochlear Implant Care With Remote Programming: The Complete Cochlear Implant Care Model

“…Until now, telemedicine options for patients have been limited. Since the onset of the COVID-19 pandemic, telemedicine infrastructure and appointments have not only increased, but both patients and healthcare workers have reported increased satisfaction with this modality (15,16). Although automated CI programming is still in development, previous studies have demonstrated the efficacy of remote programming when performed by an audiologist in real-time (17)(18)(19)(20).…”

Utility of telephone visits at an urban safety‐net hospital during 2020: A retrospective review

“…These institutional changes accelerated the uptake of telehealth in all specialties, including otolaryngology‐head and neck surgery (OHNS). 2 …”

“…These institutional changes accelerated the uptake of telehealth in all specialties, including otolaryngology-head and neck surgery (OHNS). 2 Telehealth has the potential to improve health equity because it offers increased accessibility to services for underserved patient populations, especially in rural areas where physician density is significantly lower. 3,4 And yet, some have voiced concerns that health disparities persist in telemedicine care because socially disadvantaged patients may lack the technical equipment and knowledge required to participate in video visits.…”

“…Telemedicine is the “use of electronic information and communications technologies to provide and support healthcare when distance separates the participants.” 1 During the COVID‐19 pandemic, several hospitals limited in‐person clinic visits to telehealth visits for non‐emergency medical appointments. These institutional changes accelerated the uptake of telehealth in all specialties, including otolaryngology‐head and neck surgery (OHNS) 2 …”

Telemedicine evaluation of new head and neck patients at a tertiary academic clinic during the coronavirus disease 2019 pandemic

“…Telemedicine within otolaryngology has been explored for over 30 years. 1 – 3 Previous studies suggest that the modality is well suited for this specialty given the difficulty for rural communities to access otolaryngology care, in addition to the ability for otolaryngologists to determine the need for in-person visitation from a virtual consultation and frequently make diagnoses based on objective imaging findings. 2 , 4 – 14 …”