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The World Health Organization defines telemedicine as “an interaction between a health care provider and a patient when the two are separated by distance”. The COVID-19 pandemic has forced a dramatic shift to telephone and video consulting for follow up and routine ambulatory care for reasons of infection control. Short Message Service (“text”) messaging has proved a useful adjunct to remote consulting allowing transfer of photographs and documents. Maintaining non-communicable diseases care is a core component of pandemic preparedness and telemedicine has developed to enable (for example) remote monitoring of sleep apnoea, telemonitoring of chronic obstructive pulmonary disease, digital support for asthma self-management, remote delivery of pulmonary rehabilitation. There are multiple exemplars of telehealth instigated rapidly to provide care for people with COVID-19, to manage the spread of the pandemic, or to maintain safe routine diagnostic or treatment services.Despite many positive examples of equivalent functionality and safety, there remain questions about the impact of remote delivery of care on rapport and the longer-term impact on patient/professional relationships. Although telehealth has the potential to contribute to universal health coverage by providing cost-effective accessible care, there is a risk of increasing social health inequalities if the “digital divide” excludes those most in need of care. As we emerge from the pandemic, the balance of remote versus face-to-face consulting, and the specific role of digital health in different clinical and healthcare contexts will evolve. What is clear is that telemedicine in one form or another will be part of the “new norm”.
The World Health Organization defines telemedicine as “an interaction between a health care provider and a patient when the two are separated by distance”. The COVID-19 pandemic has forced a dramatic shift to telephone and video consulting for follow up and routine ambulatory care for reasons of infection control. Short Message Service (“text”) messaging has proved a useful adjunct to remote consulting allowing transfer of photographs and documents. Maintaining non-communicable diseases care is a core component of pandemic preparedness and telemedicine has developed to enable (for example) remote monitoring of sleep apnoea, telemonitoring of chronic obstructive pulmonary disease, digital support for asthma self-management, remote delivery of pulmonary rehabilitation. There are multiple exemplars of telehealth instigated rapidly to provide care for people with COVID-19, to manage the spread of the pandemic, or to maintain safe routine diagnostic or treatment services.Despite many positive examples of equivalent functionality and safety, there remain questions about the impact of remote delivery of care on rapport and the longer-term impact on patient/professional relationships. Although telehealth has the potential to contribute to universal health coverage by providing cost-effective accessible care, there is a risk of increasing social health inequalities if the “digital divide” excludes those most in need of care. As we emerge from the pandemic, the balance of remote versus face-to-face consulting, and the specific role of digital health in different clinical and healthcare contexts will evolve. What is clear is that telemedicine in one form or another will be part of the “new norm”.
Introduction: The COVID-19 pandemic has highlighted the urgent need for innovative healthcare solutions to address rapid population growth and healthcare service disparities, especially in resource-constrained settings. Telemedicine, which enables remote patient-provider communication and care, offers great potential to improve accessibility, efficiency, and quality of healthcare delivery. However, its development in Middle Eastern (ME) countries has been relatively slow and insufficiently monitored. This scoping review summarizes recent telemedicine implementations and their associated challenges in ME countries while offering recommendations for policymakers. Methods: A search of Pubmed, Scopus, and Web of Science for articles published between January 2019 and August 2023 yielded 437 publications, of which 34 were included for data analysis. Study data were categorized using country of origin, study design, data collection methods, study subjects, telemedicine interventions, and major findings. Results: The key insights highlight the need for integrating innovative technologies into healthcare systems, increasing public awareness and education on telemedicine, diversifying research to address regional priorities, and fostering interdisciplinary collaboration to accelerate telemedicine adoption. Conclusion: In conclusion, while telemedicine has made significant progress in ME countries, ongoing challenges must be addressed to ensure equitable and effective healthcare delivery for all.
Background During the height of the COVID-19 pandemic in 2020, 11% of patients who were hospitalized in France were immediately admitted to intensive care. We aimed to identify and characterize the different types of primary care pathways of patients hospitalized for COVID-19 using patients’ self-reported experiences. Method We conducted a qualitative study using biographic interviews of patients who were hospitalized for COVID-19 between September 2020 and December 2021 in the infectious disease departments in Marseille and Nice. The biographical interviews used a life-events calendar approach to understand the sequences of clinical and care events prior to hospitalization. Results 31 pathways were described. Short care pathways (i.e., admission to hospital ≤ 3 days after symptom onset) were more likely to be reported by older patients and those with comorbidities. These pathways were characterized by closer GP surveillance and by sudden symptom onset and rapid progression of the disease. Long care pathways (i.e., >10 days after system onset) were reported more by younger patients with no comorbidities. Multiple tests and medical consultations returning false-negatives had led this population to doubt they had COVID-19. They were more likely to present severe symptoms requiring intensive care. The study revealed key importance of patients’ loved ones in the process of their hospitalization. Conclusion This study highlights that primary care management of COVID-19 patients needing hospitalization in France was particularly slow and detrimental to their health. It also underlines the need to improve the identification and monitoring of patients at risk of complications.
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