message stringlengths 5 7.37k | message_type stringclasses 3 values | message_id int64 0 2 | conversation_id int64 77.2k 898k | cluster float64 81 81 | __index_level_0__ int64 231k 2.69M |
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Please summerize the given abstract to a title | instruction | 0 | 77,200 | 81 | 231,190 |
Transition to telephone genetic counseling services during the COVID-19 pandemic | output | 1 | 77,200 | 81 | 231,191 |
The COVID-19 pandemic has significantly disrupted the delivery of healthcare services, including oncology. To ensure continuity of cancer genetic counseling at a large academic medical center while also promoting the safety of patients and staff, our team transitioned to fully remote telephone genetic counseling and testing services within 48 hr. We compare differences in the six weeks following the shift to telephone genetic counseling (post-COVID) to the six weeks preceding the pandemic (pre-COVID). We maintained 99% of our total visit capacity and saw a decrease in patient no-show rate from 9.5% to 7.3%. Of all patients who received telephone genetic counseling, fewer consented to genetic testing as compared to patients seen in-person prior to the pandemic (79% pre-COVID v. 72% post-COVID; p = .012). Four weeks after this cohort was closed for analysis, 96 out of 303 samples (32%) had not been received by the genetic testing laboratory, despite at least one reminder phone call to the patient. In 13 reported instances, a second sample was required (quality not sufficient, lost or mislabeled sample), thus delaying test results. We conclude that a rapid transition to remote genetic counseling and testing allowed uninterrupted access to cancer genetics services during to the COVID-19 pandemic. Patient compliance with sample return and higher rates of sample failure emerge as potential barriers to timely genetic testing under this service delivery model. | input | 2 | 77,200 | 81 | 231,192 |
Please summerize the given abstract to a title | instruction | 0 | 77,244 | 81 | 231,322 |
Effect of COVID-19 on dental telemedicine in Japan | output | 1 | 77,244 | 81 | 231,323 |
BACKGROUND/PURPOSE: In Japan, medical and dental care is provided by the universal health insurance system. The Ministry of Health, Labour, and Welfare (MHLW) in Japan sets the rules for health care services provided by health insurance. The MHLW issued a notice in 2020 permitting telemedicine and dental telemedicine for the first visit and for follow-up visits to prevent the spread of COVID-19 infection. We conducted this study to clarify the status of dental telemedicine during 2020. MATERIALS AND METHODS: We used data from lists obtained on the MHLW website in the analysis. We investigated the number of dental institutions conducing dental telemedicine for the first visit and for follow-up visits by prefecture. RESULTS: In each prefecture, fewer dental institutions conducted telemedicine for the first visit than for follow-up visits. Regions with large metropolitan areas had higher numbers of dental institutions conducting dental telemedicine for the first visit and follow-up visits. Private dental clinics provided the largest proportion of dental telemedicine for the first visit, and general hospitals provided the largest proportion for follow-up visits. CONCLUSION: Our study findings indicated that many dental institutions in Japan made efforts to provide dental services via dental telemedicine using the telephone or online with video to help prevent the spread of COVID-19 infection. Dental telemedicine can help patients to access dental services and dental care, thereby expanding the potential of dental telemedicine in Japan. | input | 2 | 77,244 | 81 | 231,324 |
Please summerize the given abstract to a title | instruction | 0 | 77,339 | 81 | 231,607 |
ProReal®: The ‘good enough’ online alternative to face-to-face Dramatherapy | output | 1 | 77,339 | 81 | 231,608 |
The Covid-19 restrictions have limited the access of face-to face therapies for many people and continues to effect how Dramatherapists operate. The following article offers reflections around adapting to an on-line medium, focusing more specifically around the software of ProReal. Limitations and considerations are acknowledged, including technological difficulties, computer efficacy, ambiguity tolerance and the need for careful contracting and reassurance of autonomy and control when using on-line platforms. The article ends with a short selection of vignettes from ProReal sessions. | input | 2 | 77,339 | 81 | 231,609 |
Please summerize the given abstract to a title | instruction | 0 | 77,347 | 81 | 231,631 |
Covid-19 telescreening in SUS users with risk conditions: case report | output | 1 | 77,347 | 81 | 231,632 |
ABSTRACT This case report aims to describe the conception and preliminary data of the implementation of a telescreening and telemonitoring program of covid-19 for users of the Unified Health System with risk conditions A system of telerscreening was implemented through which undergraduate students in the health area contact patients by telephone, according to periodicity and predefined criteria, to monitor the evolution of the condition In eight weeks, 2,190 attempts at remote contact were made with individuals from five health units The effective number of individuals monitored at the time this writing is 802 RESUMO O presente relato de experiência tem como objetivo descrever a concepção e os dados preliminares da implementação de um programa de telerrastreio e telemonitoramento da covid-19 para usuários do Sistema Único de Saúde com condições de risco para agravamento Foi implantado um sistema de telerrastreio por meio do qual estudantes de graduação na área da saúde contactam os pacientes via telefone, conforme periodicidade e critérios predefinidos, para monitorar a evolução do quadro Em oito semanas, foram realizadas 2 190 tentativas de contato remoto com indivíduos de cinco unidades de saúde O número efetivo de indivíduos monitorados no momento da escrita deste artigo é de 802 | input | 2 | 77,347 | 81 | 231,633 |
Please summerize the given abstract to a title | instruction | 0 | 77,404 | 81 | 231,802 |
The Utility of Televisits in Patients with Cardiac Amyloidosis during the COVID-19 Pandemic | output | 1 | 77,404 | 81 | 231,803 |
Purpose In the era of COVID-19, the televisit has become a critical means of providing healthcare for patients unable to attend in-person visits Transthyretin and light chain amyloidosis are complex diseases, that require frequent and close follow up The aim of this study was to assess the utility and effectiveness of televisit encounters for patients with cardiac amyloidosis (CA) during the COVID-19 pandemic Methods This was a prospective cohort study of consecutive patients with CA who were evaluated by televisit between March and May, 2020, at a large academic medical center Patient demographics, baseline medications and details of televisit encounters were collected from electronic medical records Patients were followed for 3 months from their first televisit for medication changes, in-person clinic visits, hospital admissions, and mortality Results Ninety-eight patients with CA were included Mean age was 76 5±9 1 yrs and 79 were male (80 6%) The number of televisits per patient is shown in Figure 1a Over 3-months follow-up, 26 patients (26 5%) were seen for either an in-person clinic visit or right heart catheterization There were 7 emergency room visits, of which 4 (4 1%) resulted in hospital admission, 1 patient (1 0%) had multiple admissions and no patient died (Figure 1b) None of the hospital admissions occurred within two weeks of a televisit Hospital admissions were due to heart failure exacerbation, sepsis, acute kidney injury and dehydration secondary to diarrhea During follow-up, 23 patients (23 5%) had medication adjustments, most commonly changes in diuretic (56 5%) and mineralocorticoid receptor antagonist (56 5%) doses Two patients were newly initiated on tafamidis, for treatment of transthyretin CA Conclusion The use of televisits for the management of patients with CA is feasible, and the low admission rate indicates that televisits are a safe and effective way to manage CA patients in the outpatient setting | input | 2 | 77,404 | 81 | 231,804 |
Please summerize the given abstract to a title | instruction | 0 | 78,021 | 81 | 233,653 |
The state of telemedicine for persons with Parkinson's disease | output | 1 | 78,021 | 81 | 233,654 |
PURPOSE OF REVIEW: The COVID-pandemic has facilitated the implementation of telemedicine in both clinical practice and research. We highlight recent developments in three promising areas of telemedicine: teleconsultation, telemonitoring, and teletreatment. We illustrate this using Parkinson's disease as a model for other chronic neurological disorders. RECENT FINDINGS: Teleconsultations can reliably administer parts of the neurological examination remotely, but are typically not useful for establishing a reliable diagnosis. For follow-ups, teleconsultations can provide enhanced comfort and convenience to patients, and provide opportunities for blended and proactive care models. Barriers include technological challenges, limited clinician confidence, and a suboptimal clinician-patient relationship. Telemonitoring using wearable sensors and smartphone-based apps can support clinical decision-making, but we lack large-scale randomized controlled trials to prove effectiveness on clinical outcomes. Increasingly many trials are now incorporating telemonitoring as an exploratory outcome, but more work remains needed to demonstrate its clinical meaningfulness. Finding a balance between benefits and burdens for individual patients remains vital. Recent work emphasised the promise of various teletreatment solutions, such as remotely adjustable deep brain stimulation parameters, virtual reality enhanced exercise programs, and telephone-based cognitive behavioural therapy. Personal contact remains essential to ascertain adherence to teletreatment. SUMMARY: The availability of different telemedicine tools for remote consultation, monitoring, and treatment is increasing. Future research should establish whether telemedicine improves outcomes in routine clinical care, and further underpin its merits both as intervention and outcome in research settings. | input | 2 | 78,021 | 81 | 233,655 |
Please summerize the given abstract to a title | instruction | 0 | 78,061 | 81 | 233,773 |
COVID-19 Pandemic-Related Practices and Policies Affecting the Continuity of Behavioral Health Care Among Children With Diabetes | output | 1 | 78,061 | 81 | 233,774 |
COVID-19 has led to substantial challenges in continuing to deliver behavioral health care to all patients, including children with chronic diseases. In the case of diabetes, maintaining strong connections among children, their families, and their care team is essential to promote and sustain daily adherence to a complex medical regimen. The purpose of this paper is to describe COVID-19 pandemic-related practices and policies affecting the continuity of behavioral health care among children with diabetes. Challenges and opportunities were encountered at the provider, patient, and family levels throughout the rapid transition period from in-person to online care to ensure continuity of services. Institutional, regional, and national policies that impacted the care team’s capacity to respond swiftly to patients’ changing needs were counterbalanced by those related to standards of care, education and training, and resource constraints. At the policy level, COVID-19 re-exposed a number of long-standing and complicated issues about professional licensure among behavioral health providers at the local and state levels and national long-distance practice restrictions during times of crisis. Issues of insurance reimbursement and regulations intended to protect the public may need to adapt and evolve as the practice of behavioral medicine increasingly takes place remotely, online, and over great distances. The sudden transition to telehealth instigated by COVID-19, in addition to the increasing recognition of the benefits of telehealth to favorably affect the reach and impact of traditional behavioral medicine services, offers an unprecedented opportunity to reimagine the medical home and continuity of care for children with diabetes. | input | 2 | 78,061 | 81 | 233,775 |
Please summerize the given abstract to a title | instruction | 0 | 78,088 | 81 | 233,854 |
Identifying and managing osteoporosis before and after COVID-19: rise of the remote consultation? | output | 1 | 78,088 | 81 | 233,855 |
Summary: The COVID-19 pandemic is influencing methods of healthcare delivery In this short review, we discuss the evidence for remote healthcare delivery in the context of osteoporosis Introduction: The COVID-19 pandemic has undoubtedly had, and will continue to have, a significant impact on the lives of people living with, and at risk of, osteoporosis and those caring for them With osteoporosis outpatient and Fracture Liaison Services on pause, healthcare organisations have already moved to delivering new and follow-up consultations remotely, where staffing permits, by telephone or video | input | 2 | 78,088 | 81 | 233,856 |
Please summerize the given abstract to a title | instruction | 0 | 78,117 | 81 | 233,941 |
Ushering in the Silver Age of Telehealth: Addressing Telehealth Disparities for Older Adults With Disabilities | output | 1 | 78,117 | 81 | 233,942 |
One silver lining of COVID-19 has been the ushering in of ‘the golden age of telehealth’. However, this unplanned rapid conversion to telehealth left many providers and clinics unprepared to address systemic barriers that adversely affect older adults, particularly those with disabilities. Data from the VA Corporate Data Warehouse suggest that the rapid adoption of telehealth in mental health clinics during COVID-19 widened telehealth utilization disparities for older Veterans (65+) with disabilities. With 4.5 million Veterans 55+ who have at least one disability more attention to addressing this widening gap is needed. For those with hearing, vision, and complex mobility impairments, there are unique challenges to initiating telehealth services. Dr. Touchett will present preliminary findings while discussing ethical and contextual considerations when using telehealth with older Veterans who have disabilities, while discussing ways to facilitate robust clinical encounters for this population. | input | 2 | 78,117 | 81 | 233,943 |
Please summerize the given abstract to a title | instruction | 0 | 78,168 | 81 | 234,094 |
Telehealth and 30-Day Readmissions Among Heart Failure Patients During the COVID-19 Pandemic | output | 1 | 78,168 | 81 | 234,095 |
This study examined whether outpatient follow-up within 14 days of discharge via telehealth visits are as effective as in-person visits for reducing 30-day readmission in heart failure (HF) patients. Using electronic health records from a large health system, we included HF patients (n=1,722) who were hospitalized during the period of March 15-July 15, 2020. Overall, 28.1% of patients received an early outpatient follow-up visit. Patients who received telehealth visits (n=119) were more likely to be older and live in areas with higher median household incomes than those with in-person visits (n=365). Thirty-day readmission rates were 20.5% during the COVID-19 period. Multivariate models showed that patients who received a telehealth (OR=0.36, 95%CI [0.23-0.56]) or an in-person (OR=0.42, 95%CI [0.31-0.57]) visit were less likely to be readmitted within 30 days compared with patients without an early outpatient follow-up. Telehealth visits were just as effective as in-person visits at reducing 30-day readmissions. | input | 2 | 78,168 | 81 | 234,096 |
Please summerize the given abstract to a title | instruction | 0 | 78,222 | 81 | 234,256 |
Digital Pathology Operations at an NYC Tertiary Cancer Center During the First 4 Months of COVID-19 Pandemic Response | output | 1 | 78,222 | 81 | 234,257 |
Implementation of an infrastructure to support digital pathology began in 2006 at Memorial Sloan Kettering Cancer Center The public health emergency and COVID-19 pandemic regulations in New York City required a novel workflow to sustain existing operations While regulatory enforcement discretions offered faculty workspace flexibility, a substantial portion of laboratory and digital pathology workflows require on-site presence of staff Maintaining social distancing and offering staggered work schedules Due to a decrease in patients seeking health care at the onset of the pandemic, a temporary decrease in patient specimens was observed Hospital and travel regulations impacted onsite vendor technical support Digital glass slide scanning activities onsite proceeded without interruption throughout the pandemic, with challenges including staff who required quarantine due to virus exposure, unrelated illness, family support, or lack of public transportation During the public health emergency, we validated digital pathology systems for a remote pathology operation Since March 2020, the departmental digital pathology staff were able to maintain scanning volumes of over 100 000 slides per month The digital scanning team reprioritized archival slide scanning and participated in a remote sign-out validation and successful submission of New York State approval for a laboratory developed test Digital pathology offers a health care delivery model where pathologists can perform their sign out duties at remote location and prevent disruptions to critical pathology services for patients seeking care at our institution during emergencies Development of standard operating procedures to support digital workflows will maintain turnaround times and enable clinical operations during emergency or otherwise unanticipated events © The Author(s) 2021 | input | 2 | 78,222 | 81 | 234,258 |
Please summerize the given abstract to a title | instruction | 0 | 78,300 | 81 | 234,490 |
Lights and Shadows of the Perception of the Use of Telemedicine by Romanian Family Doctors During the COVID-19 Pandemic | output | 1 | 78,300 | 81 | 234,491 |
Introduction: Telemedicine has emerged as a critical technology to mitigate SARS-CoV-2 infection We aim in this work to explore how general practitioners (GPs) perceived the use of telemedicine, recently recognized and reimbursed by the Public Health Insurance House (PHIH) for primary care (PC) provision Methods: A cross-sectional study was performed in 2020 in one county of Romania using an anonymous questionnaire that assessed physicians' perceptions regarding teleconsultation, reliability in tele-decision, remote pathology management, pregnant women's surveillance, patients' satisfaction with telemedicine, the need for its further reimbursement Bivariate correlation was used to measure associations between the investigated issues Results: More than a quarter of GPs (28 6%) found it easier to address patients' healthcare needs remotely, while 60 7% considered time-consuming teleconsultations compared to face-to-face visits Tele-diagnostic uncertainty was expressed by 64 3% of physicians, and a quarter were confident in tele-decisions Almost half of GPs (43%) observed patients' satisfaction with tele-visits, while half said patients encountered difficulties using technology A large percentage of doctors (62 5%) perceived that patients felt as well treated by virtual as in-person visit and 91 1% suggested post-pandemic reimbursement The results of the bivariate correlation showed that physicians who perceived positive patient feedback on telemedicine were more supportive of subsequent reimbursement Conclusion: This study showed the GPs' positive perception of the use of telemedicine Its adoption in PC has shed light on the shadows of the pandemic The time-consuming nature of teleconsultations, uncertainty in tele-decisions, patients' difficulties in using technology were seen as shadows of telecare However, most of the GPs surveyed agreed with the need for further reimbursement Future work should focus on innovative solutions for integrating telemedicine as complementary form of PC, the need for telemedicine-based training for GPs to improve capacity building, and patients' perceptions of virtual care, helping to build trust and satisfaction | input | 2 | 78,300 | 81 | 234,492 |
Please summerize the given abstract to a title | instruction | 0 | 78,401 | 81 | 234,793 |
Lemonade from Lemons-Using COVID Downtime to Teach Essential Telemedicine Skills | output | 1 | 78,401 | 81 | 234,794 |
As a result of the COVID-19 pandemic, the use of telemedicine has rapidly accelerated Our orthopaedic department created a telemedicine educational program for residents using standardized patient scenarios Training residents to use telemedicine will help them navigate through unforeseen issues that otherwise may have never been a consideration This is not only useful for today's climate but also potentially for the duration of their careers | input | 2 | 78,401 | 81 | 234,795 |
Please summerize the given abstract to a title | instruction | 0 | 78,520 | 81 | 235,150 |
Management of children with glucose-6-phosphate dehydrogenase deficiency presenting with acute haemolytic crisis during the SARs-COV-2 pandemic | output | 1 | 78,520 | 81 | 235,151 |
BACKGROUND AND OBJECTIVES: Shortage of blood during the severe acute respiratory syndrome-COV-2 (SARs-COV-2) pandemic impacted transfusion practice. The primary aim of the study is to assess management of acute haemolytic crisis (AHC) in glucose-6-phosphate dehydrogenase(G6PD)- deficient children during SARs-COV-2 pandemic, and then to assess blood donation situation and the role of telemedicine in management. METHODS: Assessment of G6PD-deficient children attending the Emergency Department (ER) with AHC from 1 March 2020 for 5 months in comparison to same period in the previous 2 years, in three paediatric haematology centres. AHC cases presenting with infection were tested for SARs-COV-2 using RT-PCR. Children with Hb (50-65 g/L) and who were not transfused, were followed up using telemedicine with Hb re-checked in 24 h. RESULTS: A 45% drop in ER visits due to G6PD deficiency-related AHC during SARs-COV-2 pandemic in comparison to the previous 2 years was observed. 10% of patients presented with fever and all tested negative for COVID-19 by RT-PCR. 33% of patients had Hb < 50 g/L and were all transfused. 50% had Hb between 50 and 65 g/L, half of them (n = 49) did not receive transfusion and only two patients (4%) required transfusion upon follow up. A restrictive transfusion strategy was adopted and one of the reasons was a 39% drop in blood donation in participating centres. CONCLUSION: Fewer G6PD-deficient children with AHC visited the ER during SARs-COV-2 and most tolerated lower Hb levels. Telemedicine was an efficient tool to support their families. A restrictive transfusion strategy was clear in this study. | input | 2 | 78,520 | 81 | 235,152 |
Please summerize the given abstract to a title | instruction | 0 | 78,527 | 81 | 235,171 |
COVID-19 and challenges of assistive technology use in Iran. | output | 1 | 78,527 | 81 | 235,172 |
PURPOSE Assistive technology users may encounter challenges and inequality in having an access to health information and care during the emergency or in a crisis time. This issue seems to be understudied in most developing countries. The aim of this study was to explore the challenges faced by Iranian people with disabilities faced during the COVID-19 pandemic as far as the use of assistive technology is concerned. METHOD A thematic analysis approach was employed to collect and analyse the data. We interviewed 10, 12 and 20 participants with physical, visual, and hearing disability, respectively during the pandemic between May to July 2020. A six-step thematic analysis method was used to identify categories and main themes. RESULTS The results revealed that people with disability were faced with some challenges in accessing information or receiving it on time during the emergency time. The lack of clear information may increase uncertainty about providing, using or maintaining assistive products. With no clear information or instruction, increased fear of infection, as well as the lack of necessary infrastructure for using available online applications, people with a disability had to rely more on others and seemed to feel disempowered. CONCLUSION Assistive technology (AT) users may not receive enough care and attention during health crisis, nor may be included in crisis management programs. Actions to create preparedness plans to meet the needs of AT users in possible future crisis seem to be necessary.IMPLICATIONS FOR REHABILITATIONAssistive technology users' voice and needs should be given priority in crisis management programs.Web accessibility barriers and information accessibility challenges need more research attention in order to create effective and timely information dissemination programs.There seems to be a research gap about AT users during health crisis, and more research in this area is needed. | input | 2 | 78,527 | 81 | 235,173 |
Please summerize the given abstract to a title | instruction | 0 | 78,540 | 81 | 235,210 |
State and federal abortion restrictions increase risk of COVID-19 exposure by mandating unnecessary clinic visits | output | 1 | 78,540 | 81 | 235,211 |
OBJECTIVE: To quantify the number of medically unnecessary clinical visits and in-clinic contacts monthly caused by US abortion regulations. STUDY DESIGN: We estimated the number of clinical visits and clinical contacts (any worker a patient may come into physical contact with during their visit) under the current policy landscape, compared to the number of visits and contacts if the following regulations were repealed: (1) State mandatory in-person counseling visit laws that necessitate two visits for abortion, (2) State mandatory-ultrasound laws, (3) State mandates requiring the prescribing clinician be present during mifepristone administration, (4) Federal Food and Drug Administration Risk Evaluation and Mitigation Strategy for mifepristone. If these laws were repealed, "no-test" telemedicine abortion would be possible for some patients. We modeled the number of visits averted if a minimum of 15 percent or a maximum of 70 percent of medication abortion patients had a "no-test" telemedicine abortion. RESULTS: We estimate that 12,742 in-person clinic visits (50,978 clinical contacts) would be averted each month if counseling visit laws alone were repealed, and 31,132 visits (142,910 clinical contacts) would be averted if all four policies were repealed and 70 percent of medication abortion patients received no-test telemedicine abortions. Over 2 million clinical contacts could be averted over the projected 18-month COVID-19 pandemic. CONCLUSION: Medically unnecessary abortion regulations result in a large number of excess clinical visits and contacts. POLICY IMPLICATIONS: Repeal of medically unnecessary state and federal abortion restrictions in the United States would allow for evidence-based telemedicine abortion care, thereby lowering risk of SARS-CoV-2 transmission. | input | 2 | 78,540 | 81 | 235,212 |
Please summerize the given abstract to a title | instruction | 0 | 78,735 | 81 | 235,795 |
Psychiatrist experience of remote consultations by telephone in an outpatient psychiatric department during the COVID-19 pandemic | output | 1 | 78,735 | 81 | 235,796 |
OBJECTIVE: In response to the COVID-19 pandemic, there has been a shift globally from face-to-face consultations to remote consultations. In our department, remote consultations have taken in the form of telephone consultations. In this paper, we set out to study a group of Irish psychiatrists’ experience of these consultations. METHODS: We identified recurrent themes in the existing literature on doctors’ experience of telephone consultations with a view to determining the applicability of these themes to a group of Irish psychiatrists. A questionnaire was developed based on themes in the literature. This was sent to all psychiatrists working in a busy psychiatric service in Dublin. RESULTS: The questionnaire response rate was 72% (n = 26/35). Diagnostic challenges, the effect of phone consultation on the therapeutic alliance, challenges associated with the use of technology and ethical concerns were identified as issues. Flexibility in the working day and convenience were identified as possible benefits to telephone consultations. CONCLUSIONS: The group that participated in this research study identified a number of challenges to carrying out successful phone consultations. This study highlights the need at our clinical site for interventions to address the issues identified by staff. The findings also highlight the requirement for larger studies with stronger methodologies to determine the generalisability of our results. | input | 2 | 78,735 | 81 | 235,797 |
Please summerize the given abstract to a title | instruction | 0 | 78,751 | 81 | 235,843 |
Geriatric Education on Telehealth (GET) Access: A medical student volunteer program to increase access to geriatric telehealth services at the onset of COVID-19. | output | 1 | 78,751 | 81 | 235,844 |
The coronavirus disease 2019 pandemic placed an unprecedented demand on health systems to rapidly shift ambulatory in-person care to virtual care. Geriatric patients face more challenges with video visit access compared to younger patients due to discomfort with technology and less access to devices and internet. Medical students at the University of Michigan created an initiative to improve access to and comfort with video visits for geriatric patients. The program's goals were to (a) explore options for the delivery of personalized training to older adults, (b) create materials for volunteers to successfully navigate conversations with patients and caregivers, (c) provide patients one-to-one remote guidance while identifying and overcoming barriers-with practice sessions to increase comfort, (d) share with the larger health system, and (e) ensure program sustainability. Over a 10-week evaluation period, providers whose patients worked with our geriatric education on telehealth access volunteers had a video visit rate of 43% compared to 19.2% prior to participation in the program (adjusted odds ratio = 3.38, 95% confidence interval = 2.49, 4.59), ultimately providing a platform for geriatric patients to foster stronger connections with their providers, while increasing Michigan Medicine's overall proportion of video telehealth visits. | input | 2 | 78,751 | 81 | 235,845 |
Please summerize the given abstract to a title | instruction | 0 | 78,761 | 81 | 235,873 |
Impact of the COVID-19 Pandemic & Telehealth Implementation in a Student Run Free Clinic | output | 1 | 78,761 | 81 | 235,874 |
Student run free clinics (SRFCs) fill a void in healthcare access for many communities and have been subject to unprecedented shifts in care delivery brought about by the coronavirus disease 2019 (COVID-19) pandemic. Our single-center institution serving uninsured patients in central Missouri switched from in-person visits to strictly telehealth visits with the onset of the pandemic. This study investigated the impact of the pandemic and the switch to telehealth on the clinic return rates by ethnicity, race, gender, rurality, and age. The pandemic led to a 47.4% reduction in the number of monthly patient encounters. Of the established SRFC population (N = 309), only 87 patients (28.2%) returned for a telehealth visit during the COVID-19 pandemic. Older patients (≥ 45 years old) were more likely to return (OR 1.71, 95% CI 1.02–2.85) for care via telehealth after the onset of the pandemic than younger patients (< 45 years old). No differences in the likelihood of returning for a telehealth visit were identified by race, ethnicity, gender, or rurality. Telehealth offers an effective solution to the complex problems faced by SRFCs during the COVID-19 pandemic and has not added barriers to care with regards to race, ethnicity, gender, or rurality at our SRFC. | input | 2 | 78,761 | 81 | 235,875 |
Please summerize the given abstract to a title | instruction | 0 | 78,763 | 81 | 235,879 |
Video consultations during the coronavirus disease 2019 pandemic are associated with high satisfaction for both doctors and patients | output | 1 | 78,763 | 81 | 235,880 |
Background and Aim: Telehealth has become the standard of care during the COVID-19 outbreak. This study aimed to assess doctor and patient satisfaction of endoscopy-related telehealth clinics with video consultations. Methods: A prospective observational study of patients consecutively booked to attend two endoscopy-related telehealth clinics at an ambulatory tertiary care setting was conducted from July to October 2020. Data collected from our previously published study using phone consultations (data collected in April–May 2020) were used as a control arm. The primary outcome (satisfaction) was assessed through the six-question score (6Q_score) as per previous research. Secondary outcomes included failure-to-attend (FTA) rate and perceived necessity of physical examination/in-person follow-up appointment. Results: There were 962 endoscopy clinic appointments between July and October, of which 157 were conducted through video. Data on 127 doctor questionnaires and 94 patient questionnaires were analyzed. The median age (years) of patients reviewed via video [57, interquartile range (IQR) 48–66] was lower than those reviewed via phone (65, IQR 55–74, P < 0.01). Patient average 6Q_score was higher with video compared to phone (85.1% vs 78.4%, P = 0.01), as was doctors' 6Q_score (97.5% vs 91.9%, P = 0.02). FTA rates remained similar between the two assessments (6.4% in April/May and 4.4% between July/October, P = 0.12). The requirement for in-person follow-up/physical examination was identified in two video consultations (1.6%). Conclusion: Video consultations during the COVID-19 outbreak demonstrated higher patient and doctor satisfaction compared to phone consultations. There was no significant difference in FTA rates and need for in-person follow-up consultations/physical examination between the telehealth two modalities. © 2021 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. | input | 2 | 78,763 | 81 | 235,881 |
Please summerize the given abstract to a title | instruction | 0 | 78,882 | 81 | 236,236 |
Rural-urban mental health disparities in the United States during COVID-19. | output | 1 | 78,882 | 81 | 236,237 |
The United States has more confirmed deaths from coronavirus 2019 (COVID-19) than any other country in the world. State governors made decisions around social distancing in their jurisdictions, which caused schools and businesses to close. Those with broadband access continued a sense or normalcy in their lives. However, for the more than 20 million people who do not have broadband access, a different set of barriers has been experienced. These challenges are especially prominent in rural communities throughout various states. The present commentary addresses how health disparities for preexisting conditions place rural residents at greater risk for morbidity during COVID-19. Reasons for physical and mental health disparities, such as limited access to hospitals or specialty providers (e.g., psychiatrists), are described. Whereas telehealth is promoted as a way to meet health access needs, especially during a pandemic, this luxury is not readily available for all U.S. residents. Recent actions brought about by the government (e.g., the CARES Act) have tried to address the rural-urban gap in telehealth, but more is needed. (PsycInfo Database Record (c) 2020 APA, all rights reserved). | input | 2 | 78,882 | 81 | 236,238 |
Please summerize the given abstract to a title | instruction | 0 | 78,892 | 81 | 236,266 |
Adapting an Outpatient Psychiatric Clinic to Telehealth During the COVID-19 Pandemic: A Practice Perspective | output | 1 | 78,892 | 81 | 236,267 |
As the demand for telepsychiatry increases during the COVID-19 pandemic, the strengths and challenges of telepsychiatry implementation must be articulated to improve clinical practices in the long term. Currently, observations within US contexts are lacking; therefore, we report on the rapid implementation of telepsychiatry and workflow experiences in a psychiatric practice based within a large health care system in southeast Texas with a national catchment area. We discuss the logistics of the implementation, including modes of communication, scheduling, coordination, and capacity; the psychological effects of web-based services, including both the loss of the physical therapeutic environment and the unique interpersonal dynamics experienced in the virtual environment; and postadoption patterns of engagement with our services and with other clinical functions affected by the rapid adaptation to telemedicine. Our art therapy group programming serves as an applied case study, demonstrating the value of a well-managed web-based program (eg, patients were receptive and well-engaged, and they appreciated the continuity of accessible service) as well as the challenges (eg, the need for backup plans and technological fallbacks, managing interruptions and telecommunication learning curves, and working around the difference in resources for art and music therapy between a well-stocked clinical setting versus clients' home spaces). We conclude from our experience that the overall strengths of telepsychiatry include receptive and well-engaged responses from patients as well as the expansion of boundaries, which provides a directly contextualized view into patients' home lives. Challenges and corresponding recommendations include the need for more careful safety planning for high-risk patients; maintaining professional boundaries in the newly informal virtual setting; designing the physical space to both frame the patient encounter and maintain work-life balance for the therapist; allowing for delays and interruptions (including an initial acclimation session); and preserving interprofessional care team collaboration when the physical locations that normally facilitate such encounters are not accessible. We believe that careful observations of the strengths and challenges of telepsychiatry during this pandemic will better inform practices that are considering telepsychiatry adoption both within pandemic contexts and more broadly thereafter. | input | 2 | 78,892 | 81 | 236,268 |
Please summerize the given abstract to a title | instruction | 0 | 78,900 | 81 | 236,290 |
Changing to remote management of a community heart failure population during COVID-19 - Clinician and Patient perspectives'. | output | 1 | 78,900 | 81 | 236,291 |
Background The COVID pandemic has challenged the traditional methods used in care of patients with heart failure (HF). Remote management of HF patients has been recommended in order to maintain routine standards of care, but satisfaction with this platform of care is unknown. We set out to address the physician and patient opinion of remote management of HF during COVID-19. Methods and Results An observational report of the use of a Structured Telephonic assessment (STA) in stable outpatient HF patients. Physician grading of the STA was complemented by 100 randomly chosen patients to ascertain patient's satisfaction and comment. 278 patients underwent a STA. Patient preference for STA was noted in 66%. Convenience was the single most cited reason for this preference (83.3%). The STA was deemed satisfactory by clinicians in 67.6%. The two-leading reasons for clinician dissatisfaction were data gaps providing a barrier to titration (55.6%) and need for clinical exam (18.9%). The annual review appointment visit subtype possessed the highest levels of satisfaction congruence amongst both clinicians and patients. Conclusion In summary, this report demonstrates reasonable patient / physician satisfaction with STA, and providing some direction on how this care platform might be sustained beyond the COVID crisis. | input | 2 | 78,900 | 81 | 236,292 |
Please summerize the given abstract to a title | instruction | 0 | 79,060 | 81 | 236,770 |
Telehealth Training During the COVID-19 Pandemic: A Feasibility Study of Large Group Multiplatform Telesimulation Training | output | 1 | 79,060 | 81 | 236,771 |
Background: Video telehealth is an important tool for health care delivery during the COVID-19 pandemic. Given physical distancing recommendations, access to traditional in-person telehealth training for providers has been limited. Telesimulation is an alternative to in-person telehealth training. Telesimulation training with both remote participants and facilitators using telehealth software has not been described. Objective: We investigated the feasibility of a large group telesimulation provider training of telehealth software for remote team leadership skills with common neonatal cases and procedures. Methods: We conducted a 90-min telesimulation session with a combination of InTouch™ provider access software and Zoom™ teleconferencing software. Zoom facilitators activated InTouch software and devices and shared their screen with remote participants. Participants rotated through skill stations and case scenarios through Zoom and directed bedside facilitators to perform simulated tasks using the shared screen and audio connection. Participants engaged in a debrief and a pre- and postsurvey assessing participants' comfort and readiness to use telemedicine. Data were analyzed using descriptive statistics and paired t tests. Results: Twenty (n = 20) participants, five Zoom and eight bedside facilitators participated. Twenty-one (21) pre- and 16 postsurveys were completed. Most participants were attending neonatologists who rarely used telemedicine software. Postsession, participants reported increased comfort with some advanced InTouch features, including taking and sharing pictures with the patient (p < 0.01) and drawing on the shared image (p < 0.05), but less comfort with troubleshooting technical issues, including audio and stethoscope (p < 0.01). Frequently stated concerns were troubleshooting technical issues during a call (75%, n = 16) and personal discomfort with telemedicine applications and technology (56%, n = 16). Conclusion: Large group telesimulation is a feasible way to offer telehealth training for physicians and can increase provider comfort with telehealth software. | input | 2 | 79,060 | 81 | 236,772 |
Please summerize the given abstract to a title | instruction | 0 | 79,246 | 81 | 237,328 |
The use of telemedicine in cardiogenetics clinical practice during the COVID-19 pandemic | output | 1 | 79,246 | 81 | 237,329 |
BACKGROUND: The COVID-19 pandemic has necessitated the rapid and widespread adoption of novel mechanisms of service delivery, including the use of telemedicine. The aim of this study was to examine the impact of COVID-19 on cardiogenetics practices. METHODS: We retrospectively analyzed the clinical characteristics of patients who were seen for cardiogenetics visits pre-pandemic (1 April-23 December 2019) and during the pandemic (1 April-23 December 2020) at Columbia University Irving Medical Center. RESULTS: Six percent (n = 6) of visits in 2019 were remote telemedicine encounters, whereas 80% (n = 106) of visits in 2020 were telemedicine encounters. In 2019, only 18% (n = 19) of the patients seen for genetic counseling were family members of probands; this percentage increased to 34% in 2020 (n = 45; p = .01). In 2020, the geographic reach of genetic counseling also extended far beyond New York State, reaching a total of 11 states as well as one patient in Puerto Rico. Genetic testing results were similar in 2019 and 2020. CONCLUSION: Despite the health-care delivery barriers created by the COVID-19 pandemic, the use of telemedicine allowed us to expand the reach of cardiovascular genetic counseling and testing. | input | 2 | 79,246 | 81 | 237,330 |
Please summerize the given abstract to a title | instruction | 0 | 79,284 | 81 | 237,442 |
Digital Health Management During and Beyond the COVID-19 Pandemic: Opportunities, Barriers, and Recommendations | output | 1 | 79,284 | 81 | 237,443 |
During the coronavirus disease (COVID-19) crisis, digital technologies have become a major route for accessing remote care. Therefore, the need to ensure that these tools are safe and effective has never been greater. We raise five calls to action to ensure the safety, availability, and long-term sustainability of these technologies: (1) due diligence: remove harmful health apps from app stores; (2) data insights: use relevant health data insights from high-quality digital tools to inform the greater response to COVID-19; (3) freely available resources: make high-quality digital health tools available without charge, where possible, and for as long as possible, especially to those who are most vulnerable; (4) digital transitioning: transform conventional offline mental health services to make them digitally available; and (5) population self-management: encourage governments and insurers to work with developers to look at how digital health management could be subsidized or funded. We believe this should be carried out at the population level, rather than at a prescription level. | input | 2 | 79,284 | 81 | 237,444 |
Please summerize the given abstract to a title | instruction | 0 | 79,306 | 81 | 237,508 |
Assimilation of Digital Health by Family Physicians in Canada | output | 1 | 79,306 | 81 | 237,509 |
Background: In recent years, governments, medical associations and other health care stakeholders have advocated digital health as a promising avenue to reduce inefficiencies, improve the delivery of health care services, increase the quality of primary care, and detect and manage infectious diseases. The present study aims to investigate the assimilation of digital health by family physicians, going beyond the simple adoption of these technologies to further understand the breadth and depth of their use in clinical practice for the diagnosis, treatment and prevention of disease, and for the monitoring of chronically-ill patients. Methods: : The study was designed as an online survey. After conducting a pre-test of the questionnaire instrument, an invitation to participate in the study was sent to 7,664 members of the Quebec Federation of General Practitioners. The online questionnaire was developed on the Qualtrics survey platform. Data was collected from 768 family physicians, representing a 10% response rate. Results: : Findings show that a large majority of the sampled physicians have yet to assimilate digital health within their medical practice. This is true in terms of both the physicians not incorporating digital health technologies into their routine work patterns and their not using these technologies to their full potential. The minority of respondents who showed a somewhat higher level of assimilation were motivated by patients’ greater requests related to digital health (e.g. for online consultations) and a greater chronic care caseload, and are characterized by their greater need for digital health training and their younger age, and use an EMR system that includes more functionalities (e.g. pharmaceutical advisers/prescribers). Conclusions: : This study has policy implications in terms of the need for greater motivation and training of family physicians in order for them to make more extensive and innovative use of digital health technologies in their medical practice, for greater interoperability and integration of the digital health tools made available to them, and for greater awareness of their patients’ emerging attitudes and behaviors with regards to digital health. These implications make even more sense in the context of the current Covid-19 pandemic. | input | 2 | 79,306 | 81 | 237,510 |
Please summerize the given abstract to a title | instruction | 0 | 79,362 | 81 | 237,676 |
The recording of mental health consultations by patients: clinical, ethical and legal considerations | output | 1 | 79,362 | 81 | 237,677 |
The topic of patients recording healthcare consultations has been previously debated in the literature, but little consideration has been given to the risks and benefits of such recordings in the context of mental health assessments and treatment. This issue is of growing importance given the increasing use of technology in healthcare and the recent increase in online healthcare services, largely accelerated by the COVID-19 pandemic. We discuss the clinical, ethical and legal considerations relevant to audio or visual recordings of mental health consultations by patients, with reference to existing UK guidance and the inclusion of a patient's perspective. | input | 2 | 79,362 | 81 | 237,678 |
Please summerize the given abstract to a title | instruction | 0 | 79,392 | 81 | 237,766 |
Teleprehabilitation during COVID-19 pandemic: the essentials of “what” and “how” | output | 1 | 79,392 | 81 | 237,767 |
In view of the COVID-19 pandemic and recent global events, the healthcare system and its services have been negatively affected, contributing towards extensive surgical backlogs. Oncological surgical candidates have been the most impacted by these changes and recommended self-isolation practices, which could result in emotional distress, sedentary behavior, and poor lifestyle habits. Preoperative supportive intervention, prehabilitation, has been proven to improve patients’ functional status and clinical trajectories. Presently, there is a critical need for prehabilitation to optimize patient health, as they experience extended wait times. However, in-hospital delivery may not be an ideal approach due to public health and safety measures. Telehealth is a field of research and practice, which has grown and evolved significantly in the last two decades, allowing for the remote delivery of health services. Therefore, the current commentary addresses the different modalities of telehealth delivery in perspective of their known feasibility and potential application in prehabilitation. | input | 2 | 79,392 | 81 | 237,768 |
Please summerize the given abstract to a title | instruction | 0 | 79,449 | 81 | 237,937 |
Launching a Statewide COVID-19 Primary Care Hotline and Telemedicine Service. | output | 1 | 79,449 | 81 | 237,938 |
To respond to the COVID-19 pandemic and recover from its aftermath, primary care teams will face waves of overwhelming demand for information and the need to significantly transform care delivery. INNOVATION Oregon Health & Science University's primary care team envisioned and implemented the COVID-19 Connected Care Center, a statewide telephone "hotline" service. RESULTS The hotline has taken more than 5825 calls from patients in 33 of Oregon's 36 counties in less than 3 months. In preliminary survey data, 86% of patients said their questions were answered during the call, 90% would recommend this service, and 70% reported a reduction in stress levels about coronavirus. In qualitative interviews, patients reported their questions answered, short wait times, nurses spent time as needed, and appropriate follow-up was arranged. CONCLUSION Academic health centers may have the capacity to leverage their extensive resources to rapidly launch a multiphased pandemic response that meets peoples' need for information and access to primary care, while minimizing risk of infection and emergency department use and rapidly supporting primary care teams to make the necessary operational changes to do the same in their communities. Such efforts require external funding in a fee-for-service payment model. | input | 2 | 79,449 | 81 | 237,939 |
Please summerize the given abstract to a title | instruction | 0 | 79,477 | 81 | 238,021 |
Lessons from the Transition to Relational Teletherapy During COVID‐19 | output | 1 | 79,477 | 81 | 238,022 |
When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship–based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context’s constraints and exploiting its strengths is key to providing high quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add‐on to a face‐to‐face practice. | input | 2 | 79,477 | 81 | 238,023 |
Please summerize the given abstract to a title | instruction | 0 | 79,689 | 81 | 238,657 |
Assessing Telehealth Through the Lens of the Provider: Considerations for the Post-COVID-19 Era | output | 1 | 79,689 | 81 | 238,658 |
Introduction: Following the coronavirus disease (COVID-19) pandemic restrictions, many health care systems turned to telehealth as an alternative to in-person care. Current literature describes sustained patient satisfaction levels with virtual care throughout the pandemic era. However, provider opinions on the transforming landscape are largely unknown. Objectives: The aim of this study is to better understand provider intentions and limitations to telehealth adoption, along with preferences by various specialties and in various settings. Methods: A mixed-methods study design was used. An attitudinal survey was sent to 2,633 health care providers at a large, quaternary, integrated health system. The survey collected deidentified quantitative and qualitative data on factors influencing provider use, satisfaction, and concerns with telehealth during and after the initial pandemic-era restrictions. Results: Five hundred eighteen providers participated in the survey. Utilization of telehealth was largely motivated by (1) improving patient access (mean 29.3%; range 28-31.6%) and (2) patient interest (mean 23%; range 17.1-28.8%). Barriers included (1) technology limitations (mean 16.1%; range 12.4-23.8%) and (2) reimbursement uncertainties (mean 15.2%; range 4.8-18.8%). Preference for virtual care was reported to be highest in ambulatory settings, including direct-to-patient care and outpatient care. Discussion: Provider preference for telehealth, regardless of specialty or health care setting, revolves around a consumer-centric care delivery model, with increased access to care being a central theme. While provider values are patient oriented, this study found that concerns included connectivity, quality, and patient privacy. Amid changing care standards and regulations, provider preference is supportive of virtual care platforms, both now and postpandemic. | input | 2 | 79,689 | 81 | 238,659 |
Please summerize the given abstract to a title | instruction | 0 | 79,755 | 81 | 238,855 |
Cardiac rehabilitation via telerehabilitation in COVID-19 pandemic situation | output | 1 | 79,755 | 81 | 238,856 |
BACKGROUND: Adherence to medication and lifestyle changes are very important in the secondary prevention of cardiovascular disease. One of the ways is by doing a cardiac rehabilitation program. MAIN BODY OF THE ABSTRACT: Cardiac rehabilitation program is divided into three phases. The cardiac rehabilitation program’s implementation, especially the second phase, center-based cardiac rehabilitation (CBCR), has many barriers not to participate optimally. Therefore, the third phase, known as home-based cardiac rehabilitation (HBCR), can become a substitute or addition to CBCR. On the other hand, this phase is also an essential part of the patients’ functional capacity. During the coronavirus disease-2019 pandemic, HBCR has become the leading solution in the cardiac rehabilitation program’s sustainability. Innovation is needed in its implementation, such as telerehabilitation. So, the cardiac rehabilitation program can be implemented by patients and monitored by health care providers continuously. SHORT CONCLUSION: Physicians play an essential role in motivating patients and encouraging their family members to commit to a sustainable CR program with telerehabilitation to facilitate its implementation. | input | 2 | 79,755 | 81 | 238,857 |
Please summerize the given abstract to a title | instruction | 0 | 79,785 | 81 | 238,945 |
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