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      Telemedicine for Women’s Health During COVID-19 Pandemic in India: A Short Commentary and Important Practice Points for Obstetricians and Gynaecologists

      Journal of Obstetrics and Gynaecology of India

      Springer India

      Telemedicine, Obstetrics and gynaecology, Pandemic, Lockdown

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          Background/purpose of study

          In view of restrictions on patients because of COVID-19 pandemic, face-to-face consultations are difficult. This short commentary tells us about the feasibility of telemedicine in this scenario in obstetrics and gynaecology.


          The database from our teleconsultation application (Apollo 247 and Askapollo) was analysed to assess feasibility of telemedicine and to design a triage pathway to reduce hospital visits for non-emergency situations and also to identify emergency cases without delay during this lockdown phase. Existing guidelines by Ministry of Health and Family Welfare (MOHFW), Government of India, were accessed.


          This was a single-doctor experience of 375 consultations done over 65 days. We also designed a triage pathway for obstetrics and gynaecology cases, and we discussed general practice for obstetricians and gynaecologists with its utility and limitations.


          Telemedicine has provided us the opportunity to manage women health problems and pregnancy concerns during this pandemic of COVID-19, except a few instances where face-to-face consultation or hospital visit is must. If we implement the triage pathway, we can minimize the risk of exposure for both patients and healthcare teams during COVID-19 pandemic.

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          Most cited references 3

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          Is Open Access

          Telemedicine in the Era of COVID-19

          Abstract: With the onset of the COVID-19 pandemic, the shifting of clinical care to telemedicine visits has been hastened. Because of current limitations in resources, many elective surgeons have been forced to venture into utilizing telemedicine, in which the standards for orthopaedic examinations have not previously been fully developed. We report our experience with protocols and methods to standardize these visits to maximize the benefit and efficiency of the virtual orthopaedic examination. At the time of scheduling, patients are asked to prepare for their virtual visit and are given a checklist. In addition to confirming audiovisual capabilities prior to the visit, patients are given specific instructions on camera positioning, body positioning, setting, and attire to improve the efficiency of the visit. During the examination, digital tools can be utilized as needed. In the setting of outpatient injury evaluations, a systematic virtual examination can aid in triaging and managing common musculoskeletal conditions. With the rapid incorporation of telehealth visits, as well as the unknown future with regard to the pandemic, the utilization and capabilities of telemedicine will continue to expand. Future directions include the development of validated, modified examination techniques and new technology that will allow for improved interactive physical examinations, as we rapidly move forward into the realm of telemedicine due to unexpected necessity.
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            Managing Urology Consultations during COVID-19 Pandemic: Application of a Structured Care Pathway

            Objectives To describe and evaluate a risk-stratified triage pathway for inpatient urology consultations during the SARS-CoV-2 (COVID-19) pandemic. This pathway seeks to outline a urology patient care strategy that reduces the transmission risk to both healthcare providers and patients, reduces the healthcare burden, and maintains appropriate patient care. Methods Consultations to the urology service during a three-week period (March 16 to April 2, 2020) were triaged and managed via one of three pathways: Standard, Telemedicine, or High-Risk. Standard consults were in-person consults with non- COVID-19 patients, High-Risk consults were in-person consults with COVID-19 positive/suspected patients, and Telemedicine consults were telephonic consults for low-acuity urologic issues in either group of patients. Patient demographics, consultation parameters and consultation outcomes were compared to consultations from the month of March 2019. Categorical variables were compared using Chi-square test and continuous variables using Mann-Whitney U test. A p-value <0.05 was considered significant. Results Between March 16 and April 2, 2020, 53 inpatient consultations were performed. By following our triage pathway, a total of 19/53 consultations (35.8%) were performed via Telemedicine with no in-person exposure, 10/53 consultations (18.9%) were High-Risk, in which we strictly controlled the urology team member in-person contact, and the remainder, 24/53 consultations (45.2%), were performed as Standard in-person encounters. COVID-19 associated consultations represented 18/53 (34.0%) of all consultations during this period, and of these, 8/18 (44.4%) were managed successfully via Telemedicine alone. No team member developed COVID-19 infection. Conclusions During the COVID-19 pandemic, most urology consultations can be managed in a patient and physician safety-conscious manner, by implementing a novel triage pathway.
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              Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)

               R. LI,  S. Pei,  B. CHEN (2020)

                Author and article information

                J Obstet Gynaecol India
                J Obstet Gynaecol India
                Journal of Obstetrics and Gynaecology of India
                Springer India (New Delhi )
                16 July 2020
                : 1-4
                GRID grid.428010.f, ISNI 0000 0004 1802 2996, Apollo Hospitals, ; Hyderabad, India
                © Federation of Obstetric & Gynecological Societies of India 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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