Telehealth-Based Evaluation Identifies Patients Who Are Not Candidates for Liver Transplantation

Konjeti, Venkata Rajesh; Heuman, Douglas M.; Bajaj, Jasmohan S.; Gilles, HoChong; Fuchs, Michael; Tarkington, Phillip E.; John, Binu

doi:10.1016/j.cgh.2018.04.048

Cited by 34 publications

(31 citation statements)

References 5 publications

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“…Recent VA data from Su et al support that the SCAN-ECHO program improves survival in liver disease. (15) Several recent VA studies by Konjeti et al (16) and John et al (17) showed that telemedicine enhanced the efficiency of liver transplant evaluations. Unfortunately, currently such programs cannot readily be implemented outside of integrated systems of care or accountable care organizations, given the regulatory and financial barriers described previously.…”

Section: Key Takeaways From the Local Pilotmentioning

confidence: 99%

Telemedicine in Liver Disease and Beyond: Can the COVID‐19 Crisis Lead to Action?

et al. 2020

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Evidence strongly supports that access to specialty gastroenterology or hepatology care in cirrhosis is associated with higher adherence to guideline-recommended care and improves clinical outcomes.Presently, only about one half of acute care hospitalizations for cirrhosis-related complications result in inpatient specialty care and the current hepatology workforce cannot meet the demand of patients with liver disease nationwide, particularly in less densely populated areas and in community-based practices not affiliated with academic centers. Telemedicine, defined as the delivery of health care services at a distance using electronic means for diagnosis and treatment, holds tremendous promise to increase access to broadly specialty care. The technology is cheap and easy to use, however, is presently limited in scale by interstate licensing restrictions and reimbursement barriers.The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Coronavirus Disease 2019 (COVID-19) has, in the short-term, accelerated the growth of telemedicine delivery as a public health and social distancing measure. Herein, we examine whether this public health crisis can accelerate the national conversation about broader adoption of telemedicine for routine medical care in non-crisis situations using a case series from our telehepatology program as a pragmatic example. Services.(1) Widespread transmission of the virus has reached pandemic proportions and is nowbeginning to cause disruptions in daily life in the United States. As part of the public health response, the Center for Medicare & Medicaid Services (CMS) and private payers are lifting restrictions on telemedicine reimbursement to facilitate healthcare access while minimizing the spread of infection.

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Section: Key Takeaways From the Local Pilotmentioning

confidence: 99%

Telemedicine in Liver Disease and Beyond: Can the COVID‐19 Crisis Lead to Action?

et al. 2020

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“…In contrast, telehepatology for liver transplant evaluations may present an opportunity to more efficiently triage patients and expedite the time from referral to evaluation and listing 11 . It can more readily identify patients with psychosocial or other barriers to transplantation and prevent futile evaluations 12 (Table 1). The innovative use of telehepatology could allow some transplant evaluations to occur on‐site while limiting the proximity of physicians and other team members to patients, a concept coined by our emergency medicine colleagues as “electronic PPE.” 13 For established patients without fibrosis, with stable chronic liver disease (e.g., viral hepatitis, metabolic‐associated fatty liver disease), or with benign liver lesions, for example, telemedicine can add convenience and efficiency.…”

Section: Pros Consmentioning

confidence: 99%

Telemedicine and Telehepatology During the COVID‐19 Pandemic

Fix

Serper

2020

Clinical Liver Disease

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“…Prior use of telemedicine in patients with advanced liver disease has demonstrated that this form of health care results in expedited transplant evaluations and more efficient triage of patients who are not transplant candidates. (86,87) The prolonged future use of telemedicine will also offer advanced hepatologic care to certain disadvantaged patients far from expert care, hopefully helping to resolve some disparities in quality and access to care. (88) Using local laboratories and providers as part of the care team along with the transplant center was part of the prepandemic care model and will be even more important in the future.…”

Section: Long-term Posttransplant Carementioning

confidence: 99%

Liver Transplantation in the Time of COVID19: Barriers and Ethical Considerations for Management and Next Steps

Jaffe¹,

Schilsky²,

Deshpande³

et al. 2020

Hepatol Commun

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Telehealth-Based Evaluation Identifies Patients Who Are Not Candidates for Liver Transplantation

Cited by 34 publications

References 5 publications

Telemedicine in Liver Disease and Beyond: Can the COVID‐19 Crisis Lead to Action?

Telemedicine in Liver Disease and Beyond: Can the COVID‐19 Crisis Lead to Action?

Telemedicine and Telehepatology During the COVID‐19 Pandemic

Liver Transplantation in the Time of COVID19: Barriers and Ethical Considerations for Management and Next Steps

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