Telehealth Sustainability in a Neurosurgery Department During the COVID-19 Pandemic

Chau, Monica; Quintero, Jorge E.; Guiliani, Ashley; Hines, Tripp; Samaan, Christopher; Seybold, Katie; Stowe, Matthew J.; Hanlon, Dean; Gerhardth, Greg A.; Horne, Craig G. van

doi:10.1016/j.wneu.2021.06.018

Cited by 6 publications

(3 citation statements)

References 17 publications

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“…ElGhamry et al [ 19 ] observed a 21% reduction in neurosurgical procedures in Newcastle, UK. Chau et al [ 20 ] from Kentucky, USA, indicated that their neurosurgical cases dropped 55% from their baseline. Idowu et al [ 9 ] in Lagos, Nigeria, found a 41.8% reduction in surgical procedures during the pandemic period.…”

Section: Discussionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic in Postoperative Neurosurgical Infections at a Reference Center in México

Soto Hernández,

González,

Ramírez

et al. 2023

Antibiotics

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The COVID-19 pandemic has had a major global impact on the treatment of hospitalized surgical patients. Our study retrospectively evaluates the impact of the COVID-19 pandemic at a neurosurgical reference center in Mexico City. We compared the number of neurosurgeries, the rate and type of postoperative infections, the causative microorganisms and in-hospital mortality rates in a 4-year period, from the pre-pandemic year 2019 until 2022. A total of 4150 neurosurgical procedures were registered. In 2020 the total number of surgeries was reduced by 36% compared to 2019 OR = 0.689 (95% CI 0.566–0.834) p ≤ 0.001, transnasal/trans sphenoidal pituitary resections decreased by 53%, and spinal surgeries by 52%. The rate of neurosurgical infections increased from 3.5% in 2019 to 5.6% in 2020 (p = 0.002). Regarding the microorganisms that caused infections, gram positive cocci accounted for 43.5% of isolates, Klebsiella spp. and Pseudomonas spp. caused one third of the infections. No significant differences were found for in-hospital mortality nor patterns of resistance to antibiotics. The number of surgeries increased in the last two years, although the infection rate has returned to pre-pandemic levels. We observed a lower impact from subsequent waves of COVID-19 and despite an increase in the number of surgeries, the surgeries have not amounted to the full pre-pandemic levels.

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Section: Discussionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic in Postoperative Neurosurgical Infections at a Reference Center in México

Soto Hernández,

González,

Ramírez

et al. 2023

Antibiotics

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“…Since the beginning of the pandemic, different studies have characterized the impact of telemedicine on health care access and identified related opportunities and challenges in various medical settings [26,[33][34][35][36][37][38][39][40][41][42]. Considering the challenges of telemedicine adoption, particularly during the COVID-19 pandemic, it is crucial that future research focuses on identifying the facilitating factors and addressing the barriers to its widespread use.…”

Section: Introductionmentioning

confidence: 99%

Facilitators of and Barriers to Accessing Hospital Medical Specialty Telemedicine Consultations During the COVID-19 Pandemic: Systematic Review

Cunha¹,

Pedro²,

Cordeiro³

2023

J Med Internet Res

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Background The COVID-19 pandemic accelerated the digital transition in health care, which required a rapid adaptation for stakeholders. Telemedicine has emerged as an ideal tool to ensure continuity of care by allowing remote access to specialized medical services. However, its rapid implementation has exacerbated disparities in health care access, especially for the most susceptible populations. Objective We aimed to characterize the determinant factors (facilitators and barriers) of access to hospital medical specialty telemedicine consultations during the COVID-19 pandemic and to identify the main opportunities and challenges (technological, ethical, legal, and social) generated by the use of telemedicine in the context of the COVID-19 pandemic. Methods We conducted a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 4 databases (Scopus, Web of Science, PubMed, and Cochrane COVID-19 Study Register) were searched for empirical studies published between January 3, 2020, and December 31, 2021, using established criteria. The protocol of this review was registered and published in PROSPERO (CRD42022302825). A methodological quality assessment was performed, and the results were integrated into a thematic synthesis. The identification of the main opportunities and challenges was done by interpreting and aggregating the thematic synthesis results. Results Of the 106 studies identified, 9 met the inclusion criteria and the intended quality characteristics. All studies were originally from the United States. The following facilitating factors of telemedicine use were identified: health insurance coverage; prevention of SARS-CoV-2 infection; access to internet services; access to technological devices; better management of work-life balance; and savings in travel costs. We identified the following barriers to telemedicine use: lack of access to internet services; lack of access to technological devices; racial and ethnic disparities; low digital literacy; low income; age; language barriers; health insurance coverage; concerns about data privacy and confidentiality; geographic disparities; and the need for complementary diagnostic tests or the delivery of test results. Conclusions The facilitating factors and barriers identified in this systematic review present different opportunities and challenges, including those of a technological nature (access to technological devices and internet services and level of digital literacy), a sociocultural and demographic nature (ethnic and racial disparities, geographic disparities, language barriers, and age), a socioeconomic nature (income level and health insurance coverage), and an ethical and legal nature (data privacy and confidentiality). To expand telemedicine access to hospital-based specialty medical consultations and provide high-quality care to all, including the most susceptible communities, the challenges identified must be thoroughly researched and addressed with informed and dedicated responses.

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“…Telemedicine has been effectively used to reduce physician exposure risks and conserve personal protection equipment (PPE) [ 3 , 11 ]. During the COVID-19 pandemic, telemedicine has been applied in different subspecialties, including neurology [ 12 ], orthopedics [ 13 ], neurosurgery [ 14 ], dermatology [ 15 ], and even in ophthalmology [ 4 ], for remote consultations and assessment. Family meetings and conversations between patients and families can be carried out by using telecommunication [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Challenges of Using Instant Communication Technology in the Emergency Department during the COVID-19 Pandemic: A Focus Group Study

Kuo

Chiu

et al. 2021

IJERPH

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A record outbreak of community-spread COVID-19 started on 10 May 2021, in Taiwan. In response to the COVID-19 pandemic, care facilities have adopted various protocols using instant communication technology (ICT) to provide remote yet timely healthcare while ensuring staff safety. The challenges of patient evaluation in the emergency department (ED) using ICT are seldom discussed in the literature. The objective of this study was to investigate the factors influencing the utility of ICT for patient assessment in emergency settings during the pandemic. The patient flow protocol and the ED layout were modified and regionalized into different areas according to the patient’s risk of COVID-19 infection. Nine iPads were stationed in different zones to aid in virtual patient assessment and communication between medical personnel. A focus group study was performed to assess and analyze the utility of the ICT module in the ED. Eight emergency physicians participated in the study. Of them, four (50%) had been directly involved in the development of the ICT module in the study hospital. Three main themes that influenced the application of the ICT module were identified: setting, hardware, and software. The setting theme included six factors: patient evaluation, subspecialty consultation, patient privacy and comfortableness, sanitation, cost, and patient acceptability. The hardware theme included six factors: internet connection, power, quality of image and voice, public or personal mode, portable or fixed mode, and maintenance. The software theme included six factors: platform choices, security, ICT accounts, interview modes, video/voice recording, and time limitation. Future studies should focus on quantifying module feasibility, user satisfaction, and protocol adjustment for different settings.

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Telehealth Sustainability in a Neurosurgery Department During the COVID-19 Pandemic

Cited by 6 publications

References 17 publications

The Impact of the COVID-19 Pandemic in Postoperative Neurosurgical Infections at a Reference Center in México

The Impact of the COVID-19 Pandemic in Postoperative Neurosurgical Infections at a Reference Center in México

Facilitators of and Barriers to Accessing Hospital Medical Specialty Telemedicine Consultations During the COVID-19 Pandemic: Systematic Review

Challenges of Using Instant Communication Technology in the Emergency Department during the COVID-19 Pandemic: A Focus Group Study

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