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      COVID-19 and telehealth, education, and research adaptations

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          Abstract

          For decades, there have been government funded services to provide healthcare telephonically to remote sites both on the earth and in the air. This capability has evolved into what we now know as telehealth. The use of telehealth dramatically accelerated as a result of concerns for patient and healthcare provider safety during the SARS-CoV2 pandemic. Similarly, concerns regarding transmission of infection have required medical schools to provide robust, easily accessible virtual education options. At short notice, faculties have had to develop new telehealth focused curriculum components. However, telehealth, online education, and internet enabled research should not be simply a new way to do traditional jobs but rather, an opportunity to take advantage of how technology can best be used to develop new and better ways to provide care, educate health care providers, and support research.

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          Most cited references15

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          Virtually Perfect? Telemedicine for Covid-19

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            The Impact of Project ECHO on Participant and Patient Outcomes: A Systematic Review.

            Project Extension for Community Healthcare Outcomes (ECHO) uses tele-education to bridge knowledge gaps between specialists at academic health centers and primary care providers from remote areas. It has been implemented to address multiple medical conditions. The authors examined evidence of the impact of all Project ECHO programs on participant and patient outcomes.
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              Is Open Access

              Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative

              Background The COVID-19 outbreak has placed the National Health Service under significant strain. Social distancing measures were introduced in the UK in March 2020 and virtual consultations (via telephone or video call) were identified as a potential alternative to face-to-face consultations at this time. Local problem The Royal National Orthopaedic Hospital (RNOH) sees on average 11 200 face-to-face consultations a month. On average 7% of these are delivered virtually via telephone. In response to the COVID-19 crisis, the RNOH set a target of reducing face-to-face consultations to 20% of all outpatient attendances. This report outlines a quality improvement initiative to rapidly implement virtual consultations at the RNOH. Methods The COVID-19 Action Team, a multidisciplinary group of healthcare professionals, was assembled to support the implementation of virtual clinics. The Institute for Healthcare Improvement approach to quality improvement was followed using the Plan-Do-Study-Act (PDSA) cycle. A process of enablement, process redesign, delivery support and evaluation were carried out, underpinned by Improvement principles. Results Following the target of 80% virtual consultations being set, 87% of consultations were delivered virtually during the first 6 weeks. Satisfaction scores were high for virtual consultations (90/100 for patients and 78/100 for clinicians); however, outside of the COVID-19 pandemic, video consultations would be preferred less than 50% of the time. Information to support the future redesign of outpatient services was collected. Conclusions This report demonstrates that virtual consultations can be rapidly implemented in response to COVID-19 and that they are largely acceptable. Further initiatives are required to support clinically appropriate and acceptable virtual consultations beyond COVID-19. Registration This project was submitted to the RNOH’s Project Evaluation Panel and was classified as a service evaluation on 12 March 2020 (ref: SE20.09).
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                Author and article information

                Contributors
                Journal
                Paediatr Respir Rev
                Paediatr Respir Rev
                Paediatric Respiratory Reviews
                Elsevier Ltd.
                1526-0542
                1526-0550
                18 June 2020
                18 June 2020
                Affiliations
                [a ]Department of Pediatrics and the Children’s Hospital of Richmond, Virginia Commonwealth University, USA
                [b ]Department of Internal Medicine, Virginia Commonwealth University, USA
                [c ]Department of Medical Education and Faculty Development, Isala Hospital, Zwolle, The Netherlands
                Author notes
                [* ]Corresponding author. Virginia Commonwealth University School of Medicine, 1000 East Broad St., PO Box 980270, Richmond, VA 23298, USA. brubin@ 123456vcu.edu brubin@ 123456mcvh-vcu.edu
                Article
                S1526-0542(20)30094-4
                10.1016/j.prrv.2020.06.009
                7301824
                32653468
                0f150a2a-0264-4e04-bf57-b8aaf0ae2383
                © 2020 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 11 June 2020
                : 11 June 2020
                Categories
                Article

                telehealth,telemedicine distance learning,covid-19
                telehealth, telemedicine distance learning, covid-19

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