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      Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic

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          Abstract

          The current coronavirus disease 2019 (COVID-19) pandemic has caused significant strain on medical centers resources. Thus, concerns about the reducing and management of COVID-19 are on the rise, as there is need to provide diagnosis, treatment, monitoring, and follow-ups during the pandemic. Therefore, the COVID-19 pandemic has radically and quickly altered how medical practitioners provide care to patients. Medical centers are now responding to COVID-19 through rapid adoption of digital tools and technologies such as telemedicine and virtual care which refer to the delivery of healthcare services digital or at a distance using Information and Communications Technology (ICT) for treatment of patients. Telemedicine is expected to deliver timely care while minimizing exposure to protect medical practitioners and patients. Accordingly, a rapid literature review was conducted, and 35 research studies published from 2019 to May 2020 were employed to provide theoretical and practical evidence on the significance of using telemedicine and virtual care for remote treatment of patients during the COVID-19 pandemic. This article provides practical guide based on how to use telemedicine and virtual care during the COVID-19 pandemic. This study provides implication on the potentials of consolidating virtual care solutions in the near future towards contributing to integrate digital technologies into healthcare.

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          Population-Level Interest and Telehealth Capacity of US Hospitals in Response to COVID-19: Cross-Sectional Analysis of Google Search and National Hospital Survey Data

          Background As the novel coronavirus disease (COVID-19) is widely spreading across the United States, there is a concern about the overloading of the nation’s health care capacity. The expansion of telehealth services is expected to deliver timely care for the initial screening of symptomatic patients while minimizing exposure in health care facilities, to protect health care providers and other patients. However, it is currently unknown whether US hospitals have the telehealth capacity to meet the increasing demand and needs of patients during this pandemic. Objective We investigated the population-level internet search volume for telehealth (as a proxy of population interest and demand) with the number of new COVID-19 cases and the proportion of hospitals that adopted a telehealth system in all US states. Methods We used internet search volume data from Google Trends to measure population-level interest in telehealth and telemedicine between January 21, 2020 (when the first COVID-19 case was reported), and March 18, 2020. Data on COVID-19 cases in the United States were obtained from the Johns Hopkins Coronavirus Resources Center. We also used data from the 2018 American Hospital Association Annual Survey to estimate the proportion of hospitals that adopted telehealth (including telemedicine and electronic visits) and those with the capability of telemedicine intensive care unit (tele-ICU). Pearson correlation was used to examine the relations of population search volume for telehealth and telemedicine (composite score) with the cumulative numbers of COVID-19 cases in the United States during the study period and the proportion of hospitals with telehealth and tele-ICU capabilities. Results We found that US population–level interest in telehealth increased as the number of COVID-19 cases increased, with a strong correlation (r=0.948, P<.001). We observed a higher population-level interest in telehealth in the Northeast and West census region, whereas the proportion of hospitals that adopted telehealth was higher in the Midwest region. There was no significant association between population interest and the proportion of hospitals that adopted telehealth (r=0.055, P=.70) nor hospitals having tele-ICU capability (r=–0.073, P=.61). Conclusions As the number of COVID-19 cases increases, so does the US population’s interest in telehealth. However, the level of population interest did not correlate with the proportion of hospitals providing telehealth services in the United States, suggesting that increased population demand may not be met with the current telehealth capacity. Telecommunication infrastructures in US hospitals may lack the capability to address the ongoing health care needs of patients with other health conditions. More practical investment is needed to deploy the telehealth system rapidly against the impending patient surge.
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            How about actively using telemedicine during the COVID-19 pandemic?

            To the editor: The first case of coronavirus disease (COVID-19) occurred in Wuhan, China, in December 2019. Outbreaks have affected most countries in the world, with rapid dissemination via unprecedented propagation. The World Health Organization (WHO) declared COVID-19 as being pandemic on March 11, 2020. Although the fatality rate of COVID-19 is about 2–5%, which is not very high, the fatality rate among the geriatric population aged over 60 years is greater than 10%. The fatality rate is even higher for individuals in their 70s and 80s [1]. Many research studies have reported that the COVID-19 pandemic causes psychiatric problems, such as anxiety and depression [2, 3]. As such, the geriatric population needs psychiatric counseling or treatment, but it is difficult for the geriatric population to visit hospitals or clinics because of the risk and fear of COVID-19 infection. Furthermore, with the current COVID-19 crisis showing signs of being prolonged, measures that address these problems are urgently needed. Telemedicine, which is also used synonymously with “remote medical care,” refers to providing clinical healthcare through electronic communication technologies rather than through in-person meetings between a patient and a doctor.4,5 The initial form of telemedicine involved the use of a telephone. The use of video calls and other telecommunication applications more recently has improved the service greatly. Through the latest advances in technology, we believe that telemedicine can improve the mental and physical health of the geriatric population. With telemedicine, patients who need care for anxiety and depression can be assisted without the requirement for visiting a hospital, and therapy for psychological stabilization can be provided via the internet, without the need for an in-person consultation with the doctor [3, 4]. For the geriatric population, telemedicine consultations can also help with overcoming isolation and loneliness due to disconnection with the external world. Moreover, by reducing the number of hospital visits for periodical consultations and prescriptions among the geriatric population with mental illnesses, telemedicine may potentially reduce the number of secondary or tertiary infections that could occur on route to the hospital or while waiting for care. Furthermore, telemedicine may also reduce the loss to follow up among psychiatric patients. Through telemedicine, doctors are able to continuously identify and manage each patient’s condition, which may prevent patients from not receiving appropriate treatment if their psychiatric symptoms worsen. During the COVID-19 pandemic, if a viral infection is suspected in a geriatric patient, telemedicine can help the doctor triage the patient and discern whether a visit to the hospital for COVID-19 testing is warranted. Additionally, for geriatric patients diagnosed with COVID-19 who have minor or no symptoms and are quarantined at home, the doctor can continuously assess the patients’ condition through telemedicine and ensure early detection of worsening symptoms to prevent missing the window of opportunity for treatment. Telemedicine is also advantageous for geriatric populations located in regions far away from the city (that is, regions without sufficient hospitals and clinics) in terms of accessing appropriate and timely medical services in many areas, including psychiatry. The positive effects of psychiatric consultation and treatment through telemedicine have been verified in many previous studies [4, 5]. In 2013, Hilty and colleagues analyzed studies on the effects of telemedicine published to date and reported that psychiatric consultation and treatment through telemedicine for people across many age groups, including the geriatric population, has an effect that is comparable to in-person care [4]. Furthermore, it was reported that there were effects across many settings, including emergency and home health care settings. We have examined how telemedicine can benefit geriatric psychiatric health in the current COVID-19 pandemic. Given the high mortality rate among the geriatric population, this population is considered as being at the highest risk for COVID-19. There is also an increased probability of social withdrawal and isolation among the geriatric population in this situation, and as direct visits to hospitals are difficult, there are greater concerns about their mental health. It is expected that telemedicine will play a useful role in protecting the mental health of the geriatric population during the COVID-19 pandemic and in other future situations associated with outbreaks of infectious diseases. 
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              Telehealth visits during the COVID-19 pandemic

              J Bell, J. BELL (2020)
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                Author and article information

                Contributors
                anthony.j.bokolo@ntnu.no
                Journal
                J Med Syst
                J Med Syst
                Journal of Medical Systems
                Springer US (New York )
                0148-5598
                1573-689X
                15 June 2020
                15 June 2020
                2020
                : 44
                : 7
                : 132
                Affiliations
                GRID grid.5947.f, ISNI 0000 0001 1516 2393, Department of Computer Science, , Norwegian University of Science and Technology NTNU, ; NO-7491 Trondheim, Norway
                Author information
                http://orcid.org/0000-0002-7276-0258
                Article
                1596
                10.1007/s10916-020-01596-5
                7294764
                32542571
                2ea84f27-62d3-42bf-8f65-0c00eb49a487
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 30 May 2020
                : 2 June 2020
                Funding
                Funded by: NTNU Norwegian University of Science and Technology (incl St. Olavs Hospital - Trondheim University Hospital)
                Categories
                Education & Training
                Custom metadata
                © Springer Science+Business Media, LLC, part of Springer Nature 2020

                Public health
                medical systems,telemedicine,virtual care,coronavirus disease 2019,remote treatment,pandemic

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