Single institution experience with telemedicine for pediatric urology outpatient visits: Adapting to COVID-19 restrictions, patient satisfaction, and future utilization.
Single institution experience with telemedicine for pediatric urology outpatient visits: Adapting to COVID-19 restrictions, patient satisfaction, and future utilization.
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DOI：
10.1016/j.jpurol.2021.05.012
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发表时间：
2021-08
影响因子：
2
通讯作者：
Long CJ
中科院分区：
文献类型：
--
作者：
Gan Z;Lee SY;Weiss DA;Van Batavia J;Siu S;Frazier J;Zderic SA;Shukla AR;Srinivasan AK;Kolon TF;Zaontz MR;Canning DA;Long CJ
到目前为止，远程医疗在我们实践中的广泛应用仅限于对某些术后患者的评估。新冠肺炎疫情对我们现有的医疗体系造成了严重压力，要求我们加强远程医疗的利用。我们假设将远程医疗扩展到儿科泌尿科的新患者和随访患者可以有效地完成，以满足患者和家长的期望。使用基于我们的电子医疗记录（EMR）的covid -19之前建立的远程医疗计划，患者和提供者在临床适当时过渡到主要的虚拟就诊。制定了指导病人日程安排的准则，提供了提供者和工作人员教育，包括为多个提供者完成视频就诊设计的流程图，并重新设计了电子病历，以纳入远程保健术语。使用电子病历记录每个提供者的VV数量，使用标准化问卷测量患者报告的结果（PRO）。在2018年5月至2020年4月期间，共有631名VV符合纳入标准。其中包括334例随访，172例新访和125例术后访视。患者就诊时的中位年龄为7岁（IQR 2-12岁），中位就诊时间为20分钟（IQR 15-30分钟），行VV术节省的中位路程为12.2英里（IQR 6.3-26.8英里）。诊断是多种多样的，包括一个标准的儿科泌尿外科实践的整个广度。其中325名患者完成了PRO问卷调查。家庭报告对视频就诊的总体满意度很高（中位数得分为10分），并认为就诊满足了他们孩子的医疗需求。90%的人表示，他们会强烈建议其他家庭进行远程医疗访问。患者和家长报告了VV的好处，包括减少了旅行成本，减少了从工作和学校请假的时间。描述视频访问（VV）顺序的程序图。这个过程从我们的日程安排团队开始，他们向家庭提供必要的信息，并确保他们可以正确地安排。鼓励家属在一个安静的地方进行探视，至少有一位家长和孩子在场。相关记录、影像和实验室研究应在来访前上传。此外，家人在探访前上传的照片及/或视频，有助探访的检查部分。VV =视频访问；AVS =访后总结。电子病历能够在全球大流行的背景下灵活地重新定向临床护理。远程医疗的加强使用已被证明是为儿科泌尿科患者提供护理的另一种方法。除了节省大量时间和成本外，家庭对这项技术表示高度满意。远程医疗仍应是医疗保健的一个关键方面，并应从手术后访问扩展到新患者和随访访问，即使随着大流行限制的放松，我们也应恢复正常做法。
Widespread utilization of telemedicine in our practice to date has been limited to the evaluation of certain post-surgical patients. The COVID-19 pandemic acutely stressed our established system and required us to enhance our utilization of telemedicine. We hypothesized that expansion of telemedicine to new and follow up patient visits for pediatric urology could be done effectively in a way that satisfied patient and parental expectations. Using a pre-COVID-19 established telemedicine program based in our electronic medical record (EMR), patients and providers transitioned to primarily virtual visits when clinically appropriate. Guidelines were formulated to direct patient scheduling, provider and staff education was provided, including a process map designed for multiple providers to complete video visits (VV), and the EMR was redesigned to incorporate telehealth terminology. The number of VV per provider was recorded using the electronic medical record, and patient reported outcomes (PRO) were measured using a standardized questionnaire. A total of 631 VV met inclusion criteria during the period of May 2018–April 2020. This included 334 follow up, 172 new, and 125 postoperative visits. The median age of patients at time of visit was 7 years (IQR 2–12 years), median visit time was 20 min (IQR 15–30 min), and the median travel distance saved by performing a VV was 12.2 miles (IQR 6.3–26.8 miles). Diagnoses were varied and included the entire breadth of a standard pediatric urology practice. The PRO questionnaire was completed for 325 of those patient visits. Families reported a high overall satisfaction with the video visits (median score of 10 out of 10) and felt that the visit met their child's medical needs. 90% stated that they would strongly recommend a telehealth visit to other families. Patients and parents reported benefits of VV including decreased travel costs and less time taken off from work and school. Program map depicting the sequence of a video visit (VV). The process begins with our scheduling team which provides the necessary information to the family and ensures that they can be scheduled properly. The family is encouraged to conduct the visit in a quiet place with at least one parent and the child present. Relevant records, imaging, and laboratory studies should be uploaded prior to the visit. In addition, pictures and/or videos uploaded by the family prior to the visit can facilitate the examination portion of the visit. VV = video visit; AVS = after visit summary. The EMR enabled nimble redirection of clinical care in the setting of a global pandemic. The enhanced use of telemedicine has proved to be an alternative method to provide care for pediatric urology patients. Families indicate a high degree of satisfaction with this technology in addition to significant time and cost savings. Telemedicine should remain a key aspect of medical care and expanded from post-operative visits to new patient and follow up visits, even as we return to our normal practices as the pandemic restrictions soften.
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影响因子：
2
作者：
Winkelman AJ;Beller HL;Morgan KE;Corbett ST;Leroy SV;Noona SW;Berry KL;Kern NG
通讯作者：
Kern NG
影响因子：
3.2
作者：
Powell RE;Stone D;Hollander JE
通讯作者：
Hollander JE
影响因子：
3.1
作者：
Ray, Kristin N.;Mehrotra, Ateev;Kahn, Jeremy M.
通讯作者：
Kahn, Jeremy M.
DOI：
10.1089/tmj.2009.0100
发表时间：
2010-03-01
期刊：
TELEMEDICINE JOURNAL AND E-HEALTH
影响因子：
--
作者：
Whited, John D.
通讯作者：
Whited, John D.
影响因子：
4.7
作者：
Smith, Anthony C.;Thomas, Emma;Caffery, Liam J.
通讯作者：
Caffery, Liam J.