Telehealth transformation: COVID-19 and the rise of virtual care

Wosik, Jedrek; Fudim, Marat; Cameron, Blake; Gellad, Ziad F.; Cho, Alex; Phinney, Donna; Curtis, Simon; Roman, Matthew; Poon, Eric G.; Ferranti, Jeffrey; Katz, Jason N.; Tcheng, James E.

doi:10.1093/jamia/ocaa067

Cited by 1,279 publications

(1,195 citation statements)

References 11 publications

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“…Acceptance of a telehealth program is especially relevant in light of the current coronavirus disease-19 (COVID-19) pandemic which has emphasised the importance of telehealth services to provide safe and accessible healthcare to vulnerable subsets of the population. [41] Our study ndings therefore reinforce the advantages of telehealth programs and con rm that safe and effective dietary advice and counselling can be provided to older adults in this format.…”

Section: Strengths and Limitationssupporting

confidence: 78%

Telephone-Delivered Dietary Intervention in Patients with Age-Related Macular Degeneration: 3-Months Post-Intervention Findings of a Randomised Controlled Trial

Tang

Mitchell

Burlutsky

et al. 2020

Preprint

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Background: There is an evidence-practice gap between the dietary recommendations for age-related macular degeneration (AMD) presented in the literature and those practiced by patients. This study reports on the 3-months post-intervention results of a randomised controlled trial (RCT) evaluating telephone-delivered dietary counselling aiming to improve dietary behaviors among patients with AMD.Methods: 155 AMD patients (57% female, aged 78 ± 8 years; control: 78, intervention: 77), primarily residing in New South Wales, Australia were recruited into the RCT at baseline. Participants completed a baseline questionnaire and short dietary questionnaire for age-related macular degeneration (SDQ-AMD). The intervention included an evidence-based nutrition resource and four monthly calls with a dietitian in addition to usual care; the control arm only received usual care. Immediately post-intervention, participants in the intervention arm were invited to repeat the SDQ-AMD and complete a feedback form. At 3-months post-intervention, all participants were invited to repeat the SDQ-AMD. Statistical analyses included t-tests and McNemar’s test to determine change in dietary intakes and proportion of participants meeting the dietary recommendations, respectively; level of significance for all statistical analyses was p <0.05. Descriptive statistics were used to describe adherence to and acceptability of the intervention.Results: At 3-months post-intervention compared to baseline, there were significant improvements within the intervention arm including increased intakes (mean serves ± SE) of dark green leafy vegetables (0.99 ± 0.17 vs 1.71 ± 0.22; p = 0.003) and legumes (0.69 ± 0.10 vs 1.12 ± 0.16; p = 0.02), and reduced intakes of specified discretionary foods (8.31 ± 0.76 vs 6.54 ± 0.58, p = 0.01). Between study arms, intakes of nuts were significantly higher in the intervention arm (control: 2.71 ± 0.32 vs intervention: 3.96 ± 0.51; p = 0.04) at 3-months post-intervention. Overall feedback about the intervention was positive, with all completers (n = 74) finding the program worthwhile and 98.7% (n = 73) indicating they would recommend it to others. Conclusion: This novel intervention was well-received and significantly improved the dietary intakes of dark green leafy vegetables, legumes and discretionary foods within the intervention arm.Trial registration: Australian New Zealand Clinical Trials Registry; ACTRN12618000527268; registered 10 April 2018.

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Section: Strengths and Limitationssupporting

confidence: 78%

Telephone-Delivered Dietary Intervention in Patients with Age-Related Macular Degeneration: 3-Months Post-Intervention Findings of a Randomised Controlled Trial

Tang

Mitchell

Burlutsky

et al. 2020

Preprint

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“…Telehealth has been identi ed as a viable option to continue providing timely care during the current COVID-19 pandemic [1] and many providers have quickly adapted to using telemedicine modalities including E-consults. Not only are E-consults a way to continue care during a quarantine period, but as our results indicate, they are also a considerable way to decrease in-person rheumatology wait times.…”

Section: Resultsmentioning

confidence: 99%

E-Consults: an effective way to decrease clinic wait times in Rheumatology

Patel¹,

Stewart

Horstman

2020

Preprint

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Background: To evaluate the effect of E-consults on wait times and resource utilization for positive antinuclear antibody (ANA) referrals in outpatient rheumatology.Methods: We conducted a pre-post study of E-consult implementation for positive ANA referrals. We retrospectively reviewed “positive ANA” referrals from 1/2015-3/2017. A statistical process control chart was created to display monthly average wait times for in-person clinic visits and to identify special cause variation. Final Diagnoses, wait times and resource utilization were recorded and compared between E-consults and in-person referrals.Results: There were 139 referrals for positive ANA with 126 occurring after E-consult implementation in August 2015. Forty-four percent (55/126) of referrals were E-consults; 76% did not have an in-person visit after initial electronic rheumatology recommendation. A control chart demonstrated special cause variation in the form of a shift from June 2016 – January 2017, suggesting a temporal association between decreased wait times and the implementation of E-consults. Eleven patients were diagnosed with ANA-associated rheumatic disease; the majority of patients (73%, 86/139) did not have a rheumatologic diagnosis. Overall E-consults utilized more labs than in-person visits, but this was not statistically significant. In-person visits utilized more imaging studies, which was statistically significant. Conclusion: E-consults are an effective way to address positive ANA consults without significant increase in resource utilization and were temporally associated with decreased wait times for in-person visits.

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“…The interpretation of these results could be limited by the circumstances created by the COVID-19 pandemic. [21] Repeated use of the service might occur for these patients, if they lack other alternatives. Those with higher educational levels were also more likely to use the service and experienced greater satisfaction with the service, contrary to other ndings.…”

Section: Discussionmentioning

confidence: 99%

Patients’ Perceptions and Satisfaction Regarding Teleconsultations During the COVID-19 Pandemic in Jeddah, Saudi Arabia

Magadmi

Kamel

Magadmi

2020

Preprint

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Background: The coronavirus disease 2019 (COVID-19) pandemic has resulted in the widespread implementation of teleconsultation. Teleconsultation provides remote communication and reduces the risk of virus transmission. However, patients’ perceptions and satisfaction are relevant to ensuring the quality of the service. Thus, this study aimed to evaluate patients’ perceptions and satisfaction regarding teleconsultations during the COVID-19 pandemic in Jeddah.Methods: This was a cross-sectional study using an electronic questionnaire to assess patients’ perceptions and satisfaction regarding teleconsultations during May 2020. A total of 407 participants were included.Results: Most (38.6%) participants were aged 40 to 59 years, women (73.2%), and had a university education (70.8%). Patients’ perceptions of the effectiveness of teleconsultation ranged from 71.43% to 88.77% and their satisfaction level ranged between 59.40% and 83.96%. Older patients who had favorable outcomes from teleconsultation strongly agreed about the effectiveness of teleconsultation and were more satisfied. Patients with higher education levels who used the service only once were more satisfied with the experience. Moreover, those patients with greater age and educational levels and those who called for emergencies and to request medication refills were more likely to use teleconsultation in the future beyond the COVID-19 pandemic. When asked about reasons for dissatisfaction, 70% of the participants were unhappy with the wait time for a teleconsultation.Conclusions: Most patients were satisfied with the teleconsultations during the COVID-19 pandemic. However, a better understanding of patients’ perceptions and reasons for dissatisfaction are fundamental in the planning and implementation of teleconsultations in Saudi Arabia.

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Telehealth transformation: COVID-19 and the rise of virtual care

Cited by 1,279 publications

References 11 publications

Telephone-Delivered Dietary Intervention in Patients with Age-Related Macular Degeneration: 3-Months Post-Intervention Findings of a Randomised Controlled Trial

Telephone-Delivered Dietary Intervention in Patients with Age-Related Macular Degeneration: 3-Months Post-Intervention Findings of a Randomised Controlled Trial

E-Consults: an effective way to decrease clinic wait times in Rheumatology

Patients’ Perceptions and Satisfaction Regarding Teleconsultations During the COVID-19 Pandemic in Jeddah, Saudi Arabia

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