Telemedicine in an Academic Movement Disorders Center during COVID-19.
Telemedicine in an Academic Movement Disorders Center during COVID-19.
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DOI：
10.14802/jmd.20099
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发表时间：
2021-05
影响因子：
3.9
通讯作者：
Factor SA
中科院分区：
文献类型：
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作者：
Esper CD;Scorr L;Papazian S;Bartholomew D;Esper GJ;Factor SA
在新型冠状病毒病（COVID-19）大流行期间，远程医疗在运动障碍神经病学领域迅速发展，以保持临床护理，同时降低亲自就诊的风险。我们提供了在COVID-19大流行期间在一个大型学术性运动障碍诊所中快速实施虚拟就诊的数据。我们描述了向虚拟就诊的战略转变，并回顾性地研究了影响转换为远程医疗就诊能力的因素，使用历史流行前的亲自数据作为比较，包括人口统计学，距离驱动和诊断分布，并额外关注使用深部脑刺激器的患者。在五周的时间里，共进行了686次远程医疗访问（占先前计划的门诊访问的60%）。参与者的平均年龄为65岁，45%为女性，73%为白人。男性更有可能进行过渡（p = 0.02）。远程医疗患者的居住地距离诊所远于亲自就诊的患者（66.47 km vs. 42.16 km，p < 0.001），年龄与转换无关，患者满意度没有变化。与大流行前的现场就诊相比，远程医疗所见的运动障碍诊断分布发生了显著变化（p < 0.001）。使用脑深部电刺激器的患者更有可能使用远程医疗（11.5% vs. 7%，p < 0.001）。远程医疗在运动障碍患者的护理方面是可行的、可行的和相关的，尽管妇女和少数民族的保健差距似乎很明显。在我们的研究中，使用深部脑刺激器的患者更喜欢远程医疗。需要进一步的研究来探索这些发现。
Telemedicine has rapidly gained momentum in movement disorder neurology during the coronavirus disease (COVID-19) pandemic to preserve clinical care while mitigating the risks of in-person visits. We present data from the rapid implementation of virtual visits in a large, academic, movement disorder practice during the COVID-19 pandemic. We describe the strategic shift to virtual visits and retrospectively examine elements that impacted the ability to switch to telemedicine visits using historical prepandemic in-person data as a comparator, including demographics, distance driven, and diagnosis distribution, with an additional focus on patients with deep brain stimulators. A total of 686 telemedicine visits were performed over a five-week period (60% of those previously scheduled for in-office visits). The average age of participants was 65 years, 45% were female, and 73% were Caucasian. Men were more likely to make the transition (p = 0.02). Telemedicine patients lived farther from the clinic than those seen in person (66.47 km vs. 42.16 km, p < 0.001), age was not associated with making the switch, and patient satisfaction did not change. There was a significant shift in the distribution of movement disorder diagnoses seen by telemedicine compared to prepandemic in-person visits (p < 0.001). Patients with deep brain stimulators were more likely to use telemedicine (11.5% vs. 7%, p < 0.001). Telemedicine is feasible, viable and relevant in the care of movement disorder patients, although health care disparities appear evident for women and minorities. Patients with deep brain stimulators preferred telemedicine in our study. Further study is warranted to explore these findings.