Telemedicine and the Interdisciplinary Clinic Model: During the COVID‐19 Pandemic and Beyond

Abstract

The emergence of the novel coronavirus disease 2019 (COVID-19) and the subsequent need for physical distancing have necessitated a swift change in health care delivery. Prior to the COVID-19 outbreak, many institutions utilized an interdisciplinary clinic model including both a laryngologist and a speech-language pathologist for the evaluation of patients with voice, swallowing, and upper airway disorders. To improve access, many providers are pursuing the use of interdisciplinary telemedicine to provide individualized patient-centered care while allowing for physical distancing. The purpose of this commentary is to review the current literature regarding telemedicine in laryngology and speech-language pathology as well as the current and future states of practice for interdisciplinary tele-evaluations.

Laryngeal complications of COVID‐19

“…In only a few months, it has changed the way otolaryngologists think about how we protect ourselves in the office and operating room, [1][2][3][4][5][6] how we think about aerosolizing procedures, [7][8][9][10][11][12] and how we participate in telemedicine. [13][14][15][16][17] Several aspects of the pandemic affect otolaryngologists in particular. As surgeons of the head and neck, tracheostomy management, anosmia evaluation, and evaluation of upper respiratory tract symptoms fall under the otolaryngologist's purview.…”

“…The COVID‐19 pandemic caused by the novel SARS‐CoV‐2 virus has upended the world of otolaryngology. In only a few months, it has changed the way otolaryngologists think about how we protect ourselves in the office and operating room, 1‐6 how we think about aerosolizing procedures, 7‐12 and how we participate in telemedicine 13‐17 …”

Obesidade Em Tempos De Covid-19: Recomendações Para Viver Saudável Na Pandemia

“…Desse modo, foram encontrados: um estudo caso-controle observacional (ASIAEE et al, 2020), um estudo de coorte (ROUHANI et al, 2020), um clínico-epidemiológico (LECHIEN et al, 2020), e cinco apresentaram orientações e/ou diretrizes de políticas publicas para a terapia vocal no contexto da pandemia do COVID-19. (CANTARELLA et al, 2020;CASTILLO-ALLENDES et al 2020;MATTEI et al, 2020;PATTERSON et al, 2020;ZUGHNI et al, 2020). O estudo de Asiaee et al (2020) visou comparar indivíduos infetados pelo SARS-CoV-2 com pessoas saudáveis a fim de avaliar os efeitos da doença nos parâmetros vocais.…”

Telepráctica de la terapia vocal

“…La endoscopía laríngea puede generar gotitas respiratorias que serían un riesgo de infección para los otorrinolaringólogos que realizan los exámenes [36]. La recomendación es evitar este tipo de prueba y asegurarse de que el estudio presencial es necesario y urgente, en caso de requerirlo [36,37]. Por ende, se sugiere discutir con los pacientes sobre cómo actuar si no es posible tener una observación de laringe previa [20] y advertirles esta eventual limitación por la que no podrán saber cuál es su diagnóstico mientras no reciban esta intervención [37].…”

“…La recomendación es evitar este tipo de prueba y asegurarse de que el estudio presencial es necesario y urgente, en caso de requerirlo [36,37]. Por ende, se sugiere discutir con los pacientes sobre cómo actuar si no es posible tener una observación de laringe previa [20] y advertirles esta eventual limitación por la que no podrán saber cuál es su diagnóstico mientras no reciban esta intervención [37]. El reto está en que la evaluación sea completa [20] aún si no se puede contar con la endoscopía laríngea.…”