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      Telemedicine and Smart Working: Recommendations of the European Association of Urology

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          Abstract

          Context

          Telemedicine provides remote clinical support using technological tools. It may facilitate health care delivery while reducing unnecessary visits to the clinic. The coronavirus disease 2019 (COVID-19) outbreak has caused an abrupt change in our daily urological practice, converting many of us to be reliant on telehealth.

          Objective

          To provide practical recommendations for effective use of technological tools in telemedicine.

          Evidence acquisition

          A Medline-based and gray literature search was conducted through April 2020. We selected the most relevant articles related to “telemedicine” and “smart working” that could provide important information.

          Evidence synthesis

          Telemedicine refers to the use of electronic information and telecommunications tools to provide remote clinical health care support. Smart working is a model of work that uses new or existing technologies to improve performance. Telemedicine is becoming a useful invaluable tool during and even beyond the COVID-19 pandemic. It is time for us to formalize the place of telemedicine in routine urological practice, and it is our responsibility to adapt and learn about all the tools and possible strategies for their optimal implementation during the pandemic to ensure that the quality of care received by patients and the outcomes of patients and their families are of the highest standard.

          Conclusions

          Telemedicine facilitates specialized urological clinical support at a distance, solves problems of limitations in mobility, reduces unnecessary visits to clinics, and is useful for reducing the risk of viral transmission in the current COVID-19 outbreak. Furthermore, both personal and societal considerations may favor continued use of telemedicine, even beyond the COVID-19 pandemic.

          Patient summary

          Telemedicine in urology offers specialized remote clinical support to patients, similar to face-to-face visits. It is very useful for reducing unnecessary visits to the clinic, as well as reducing the risk of contagion in the current coronavirus disease 2019 (COVID-19) pandemic.

          Take Home Message

          Telemedicine facilitates specialized urological clinical support at a distance, solves problems of limitations in mobility, reduces unnecessary visits to clinics, and is useful for reducing the risk of viral transmission in the current coronavirus disease 2019 (COVID-19) outbreak.

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          Most cited references14

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          Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

          In December 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) emerged in China and has spread globally, creating a pandemic. Information about the clinical characteristics of infected patients who require intensive care is limited.
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            Virtually Perfect? Telemedicine for Covid-19

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              Is Open Access

              Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action

              On March 11, 2020, the World Health Organization declared the coronavirus disease 2019 (COVID-19) outbreak as a pandemic, with over 720,000 cases reported in more than 203 countries as of 31 March. The response strategy included early diagnosis, patient isolation, symptomatic monitoring of contacts as well as suspected and confirmed cases, and public health quarantine. In this context, telemedicine, particularly video consultations, has been promoted and scaled up to reduce the risk of transmission, especially in the United Kingdom and the United States of America. Based on a literature review, the first conceptual framework for telemedicine implementation during outbreaks was published in 2015. An updated framework for telemedicine in the COVID-19 pandemic has been defined. This framework could be applied at a large scale to improve the national public health response. Most countries, however, lack a regulatory framework to authorize, integrate, and reimburse telemedicine services, including in emergency and outbreak situations. In this context, Italy does not include telemedicine in the essential levels of care granted to all citizens within the National Health Service, while France authorized, reimbursed, and actively promoted the use of telemedicine. Several challenges remain for the global use and integration of telemedicine into the public health response to COVID-19 and future outbreaks. All stakeholders are encouraged to address the challenges and collaborate to promote the safe and evidence-based use of telemedicine during the current pandemic and future outbreaks. For countries without integrated telemedicine in their national health care system, the COVID-19 pandemic is a call to adopt the necessary regulatory frameworks for supporting wide adoption of telemedicine.
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                Author and article information

                Contributors
                Journal
                Eur Urol
                Eur. Urol
                European Urology
                European Association of Urology. Published by Elsevier B.V.
                0302-2838
                1873-7560
                10 July 2020
                10 July 2020
                Affiliations
                [a ]Instituto de Cirugía Urológica Avanzada (ICUA), Madrid, Spain
                [b ]Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA
                [c ]S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
                [d ]Uro-oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
                [e ]European Association of Urology, Arnhem, The Netherlands
                [f ]Academic Urology Unit, University of Sheffield, Sheffield, UK
                [g ]Academic Urology Unit, University of Aberdeen, Aberdeen, UK
                [h ]Department of Urology, Katholieke University, Leuven, Belgium
                [i ]Department of Urology, La Paz University Hospital, Madrid, Spain
                [j ]Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands
                Author notes
                [* ]Corresponding author. Department of Urology, La Paz University Hospital, Paseo de la Castellana 261, Madrid 28046, Spain. Tel. +34 917 277 305, Fax: +34 917 277 070. juangomezr@ 123456gmail.com
                Article
                S0302-2838(20)30460-7
                10.1016/j.eururo.2020.06.031
                7347487
                32654801
                f4d4a040-47e1-467b-84b9-ff1b0c121aaf
                © 2020 European Association of Urology. Published by Elsevier B.V. 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
                Categories
                Article

                Urology
                covid-19,telehealth,telemedicine,telework,video visit,social media,smart work,outbreak
                Urology
                covid-19, telehealth, telemedicine, telework, video visit, social media, smart work, outbreak

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