scholarly journals P101 Remote risk stratification of dyspnoea in acute respiratory disorders and applications for COVID-19 and future pandemics: a systematic review of the literature

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Catherine Dominic ◽  
Yuti Khare ◽  
Anuradha Ponnapalli ◽  
Shivani Ganesh ◽  
Gaurav Bhalla ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Respiratory Distress ◽  
Severe Respiratory Distress ◽  
Respiratory Disorders ◽  
Telephone Consultation ◽  
Face To Face ◽  
Video Consultation ◽  
Video Telephone ◽  
Remote Assessment ◽  
Liver Transplant Recipients

Abstract Background Due to the highly infectious nature of the disease, a large amount of community-based triage of COVID-19 is performed by video/telephone consultation, especially in primary care. This presented clinicians with a new challenge in risk stratification of patients with dyspnoea due to suspected COVID19. This review searched existing literature to identify existing modalities to remotely assess patients with acute respiratory distress, which can be adapted for the COVID-19 pandemic and in future similar situations. Methods We conducted a systematic search of Medline, Embase and Medrxiv for studies of the remote assessment of dyspnoea in acute respiratory disorders in adults/children. The study was registered on PROSPERO (ID: CRD42020202292): 3014 abstracts were screened independently by two reviewers and 32 studies were progressed to full text screening. Results Five studies were selected for review, including 1317 patients. Two studies assessed video consultation, two assessed telephone related triage tools, and one study assessed an online triage tool for dyspnoea. In one study, video consultation was found to have 83% sensitivity for diagnosing ‘severe’ respiratory distress in comparison to face-to-face assessment. The online triage tool was found to have 87.5% sensitivity for detecting dyspnoea requiring emergency level care. Conclusion A range of successful remote risk stratification tools and clinical features were identified for assessing dyspnoea severity which can be adapted to COVID-19 and future pandemics to assess respiratory distress via telemedicine. These findings will influence development of comprehensive evidence-based tools to assess dyspnoea which will reduce resource strain during current/future pandemics. References Loinaz C, Marcacuzco A, Fernández-Ruiz M, Caso O, Cambra F, San Juan R, et al. Varied clinical presentation and outcome of SARS-CoV-2 infection in liver transplant recipients: Initial experience at a single center in Madrid, Spain. Transpl Infect Dis Off J Transplant Soc. 2020 Jun 20;e13372.

scholarly journals TP10.2.9The effect of COVID-19 on Breast clinic follow ups – a change in future practice?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Carol Norman ◽  
Lilia Ragad ◽  
Anupama Nagarajakumar ◽  
Maryam Alam Khan ◽  
Michal Uhercik ◽  
...  
Keyword(s):  
University Hospital ◽  
Electronic Patient Records ◽  
Breast Clinic ◽  
Telephone Consultation ◽  
Face To Face ◽  
Video Telephone ◽  
Malignant Breast ◽  
The Uk ◽  
Future Practice

Abstract Aims Prior to March 2020, at Princess Royal University Hospital (PRUH), Kings College NHS Foundation Trust, almost daily face to face benign/malignant breast clinic follow ups occurred. On March 23rd 2020 the UK went into official COVID-19 pandemic lockdown. The effect on elective follow up practice was swift with cancellation, triaging and replacement of face-to-face by telephonic/virtual consultations. We compared the change of follow up pattern, pre and post COVID-19. Could this effect the future of consultations at PRUH? Methods A comparison of all patients attending PRUH breast unit outpatients in January 2020 (preCOVID-19) for follow up, with those attending in April 2020 (postCOVID-19). Data collection from clinic lists and electronic patient records, with Excel version 16 analysis. Results 343 patient follow up consultations 01/2020. 53 patient follow up consultations 04/2020. Malignant cases: January 65%, April 60% Benign/B3 cases: January 35%, April 20% Summary follow up types. Conclusions Impact of COVID has been widespread in our practice. Our results show a significant reduction in face-to-face appointments, to allow social distancing. Further evaluation of this model will show its sustainability. Patient satisfaction will have to be assessed, with a view to a full move to video/telephone consultation where indicated.

scholarly journals P066 Telephone clinics: what are our patients saying?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Muhammad Azhar Abdullah ◽  
Nicholas Heng ◽  
Sajjad Noor ◽  
Urooj Ahmed ◽  
Clare Lavery ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Action Plan ◽  
Phone Call ◽  
Telephone Consultation ◽  
Face To Face ◽  
Video Consultation ◽  
Patient Groups ◽  
To Receive ◽  
Good Patient Satisfaction

Abstract Background/Aims  Telemedicine has not previously been a regular part of routine rheumatology services.Our department adopted telephone clinics during the COVID-19 pandemic. We assessed patient satisfaction by conducting a feedback survey. Our aim was to obtain a patient perspective on remote consultations and on preferred future follow up options including video or face-to-face consultations. Methods  The cohort included 160 rheumatology patients who had a telephone consultation between May and mid-June 2020. All patients consented to receive a further phone call by a different member of the team. Patients had to answer a questionnaire about recent consultation and to rate this on a scale of 1-5. Other questions included whether all their queries were answered; clear action plan made; perceived benefits or disadvantages of telephone consultation; and views about future follow up and any additional comments. Results  71.9% of 160 patients were females while 28.1 % males. Mean age 58.6 yrs. More than half of the patients (60.6%) had a diagnosis of inflammatory arthritis, followed by connective tissue disease (19.3%), other diagnosis (8.1% ) & vasculitis (5.6%). 94.4 % of the patients in this study were return appointments-the remainder new. Feedback results revealed 92.5% patients were satisfied with their consultation with mean score of 4.3/5 (5=best,1= worst). More than 80% agreed that all their queries were answered and a clear action plan was formed during consultation. However ,71.2% would want a face to face consultation if given choice while 54 % happy to have further follow up over the phone. 65% of patients preferred not to have video consultation. Subgroup analysis showed that majority of patients who would accept video consultation were aged between 30-39. Most common benefits described were noted to be convenience; reduced time of work; travel time and safety during pandemic, whilst difficulty in describing symptoms; hearing problems; and severity of disease were disadvantages raised, but numbers were small in our cohort. Conclusion  Telephone clinics were the mainstay during the COVID-19 pandemic.The large majority of the rheumatology patients in our cohort were highly satisfied with this form of consultation. However, interestingly the majority (71% ) would still prefer face-to-face consultation as follow up in the future. Regular follow up in carefully selected patient groups can successfully be performed by telephone clinics with good patient satisfaction. This would help increase capacity within the clinic setting. Disclosure  M. Abdullah: None. N. Heng: None. S. Noor: None. U. Ahmed: None. C. Lavery: None. S. Bawa: None.

scholarly journals On-line memory clinic – piloting a hybrid model

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S225-S225
Author(s):  
Rahul Tomar
Keyword(s):  
Digital Literacy ◽  
Cognitive Test ◽  
Remote Memory ◽  
Limiting Factor ◽  
Memory Clinic ◽  
Improvement Project ◽  
Telephone Consultation ◽  
Face To Face ◽  
Video Consultation ◽  
On Line

AimsQuality improvement project was undertaken to reorganise memory clinic to incorporate both virtual and in-person consultation (Hybrid Virtual model), as depicted in the following model:MethodTele triage conducted to ascertain information from patient and carer. This reduced time for face to face assessment.Nurse did face to face assessment to complete cognitive test (Addenbrooke's Cognitive Examination III) & carer completed Bristol Activities of Daily Living scale. Nurse would also do BP, PR, oxygen sats & temp.Nurse discussed the assessment with the consultant (who is in the inpatient unit) on line using MS TEAMSConsultant would then see patient on line, confirm diagnosis, answer questions, give information on medication and post prescription (if required)Feedback was collected using Telehealth Satisfaction questionnaireResultHybrid remote memory clinic was started on 29/09/20. A total of 37 patients were seen in this clinic by 31/01/21.Collected feedback from 21 patients was generally positive –Information provided on video consultation prior to assessment -18 reported it as excellentHow well you privacy was respected – 21 reported it as excellent.Information you received on the treatment – 18 reported it as excellentConclusionThe hybrid remote memory clinic was more effective than telephone consultation or on line only consultation as it was –Easy to establishing rapportPhysical examination could be performedDigital literacy was no longer a limiting factorPrescribing medication was slightly more difficult but possible

Patient feedback on a new method of consulting with the GP; an analysis of responses by users of online triage software

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696773
Author(s):  
Abi Eccles ◽  
Mike Hopper ◽  
Helen Atherton
Keyword(s):  
Free Text ◽  
Telephone Consultation ◽  
Face To Face ◽  
Potential Barriers ◽  
Online Consultation ◽  
Patient Feedback ◽  
Levels Of Use ◽  
Negative Perceptions ◽  
Context Dependent ◽  
Feedback Data

BackgroundOnline triage software is a new way to triage patients online that allows patients to describe their problem via an online form. A GP then contacts the patient to arrange either a face-to-face or telephone consultation.AimThis study aimed to explore use of online consultation software and gain insight into patients’ experiences of using online consultations, identifying potential barriers and facilitators to use.MethodThis is a mixed methods retrospective study analysing data about patient users and their associated feedback. Data from a sample of 5591 patients were quantitatively analysed to describe characteristics of users. 576 out of the 5591 users left free-text feedback comments on their experience of use. These were thematically analysed.ResultsThe highest levels of use were observed in 25–35-year olds and lowest from those aged >65. Key themes identified included convenience, consultation quality, appropriateness, resource-use and functionality. Within each, a range of subthemes were present representing both positive and negative perceptions, suggesting that experiences of using online triage varied and were often context-dependentConclusionThere are various advantages to online triage software, but these are context-dependent. Therefore, such applications should be offered as an additional way to contact the GP surgery, rather than a replacement for more established methods, to ensure appropriate and equal access for patients.

scholarly journals 829 Is There an Ongoing Role For 'Telephone Triage Clinics' Post COVID-19?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
B Holmes ◽  
U Mirza ◽  
C Manning ◽  
R Cooke ◽  
R Jugdey
Keyword(s):  
Common Theme ◽  
Telephone Triage ◽  
Telephone Consultation ◽  
Face To Face ◽  
Clinician Satisfaction ◽  
Set Up ◽  
Local Protocol ◽  
Telephone Questionnaire

Abstract Introduction COVID-19 has placed unprecedented demand on services at ELHT and it has become necessary to have telephone clinics to reduce the number of face-to-face clinics. A ‘telephone triage clinic’ was set up for referrals from A&E. Our project evaluated patient and clinician satisfaction on this. Method We carried out a retrospective telephone questionnaire with patients over a one-week period during the pandemic. We focussed on overall satisfaction of the consultation and quality of communication. Consultants were also surveyed for their opinion on the clinics. Results From 30 patients, 77% said they were ‘very satisfied’ with the overall experience. 80% of patients were ‘very satisfied’ with the overall length of the telephone consultation. 50% of patients felt the clinician was only ‘adequately’ able to assess them over the telephone. The consultants were less satisfied with the overall experience of telephone consultation. A common theme was that they felt ED documentation could be improved to help inform ongoing management. Conclusions Overall, patients were satisfied with the consultations. It has been successful in minimising face to face consultations however some presentations necessitate further evaluation. We need to identify those injuries appropriate for virtual follow up and design a local protocol for these.

scholarly journals Implementation of podiatry telephone appointments for people with rheumatic and musculoskeletal diseases

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
J. L. Palmer ◽  
H. J. Siddle ◽  
A. C. Redmond ◽  
B. Alcacer-Pitarch
Keyword(s):  
Musculoskeletal Diseases ◽  
Cost Effective ◽  
Time Frame ◽  
Teaching Hospitals ◽  
Potential Cost ◽  
Foot Health ◽  
Telephone Consultation ◽  
Face To Face ◽  
Initial Intervention

Abstract Background Foot health problems are common in the general population, and particularly so in people with rheumatic and musculoskeletal disorders (RMD). Several clinical guidelines state that people with RMDs should have access to foot health services, although service capacity is often limited. The current COVID-19 pandemic has increased the need for alternative ways to provide patient care. The aim of this clinical audit was to review a newly implemented telephone follow-up appointment service conducted within the Rheumatology Podiatry Department in Leeds, UK. Methods Fifty-eight patients attending the Rheumatology Podiatry Department at Leeds Teaching Hospitals NHS Trust were contacted by telephone approximately 6–8 weeks following initial intervention. During the telephone consultation, all patients were asked pre-defined questions relating to their symptoms, intervention efficacy, the need for further appointments and their preference for the type of consultation. To assess the cost of the telephone consultation the number of attempts needed in order to make successful contact, the duration of the call and the number of telephone follow-up appointments completed in a working day were also recorded. Results Twenty-five patients (43%) were successfully contacted within the 6–8 weeks stipulated time frame and were included in the analysis. Of the 25 contacted, twelve (48%) patients were successfully contacted on the first attempt. Ten (40%) were successfully contacted on the second attempt. The remaining three patients (12%) required 3 or more attempts to make successful contact. Telephone consultations were estimated not to last longer than 10 min, including notes screening and documentation. Eleven patients (44%) reported an improvement in their symptoms, thirteen (52%) reported no change and one patient (4%) reported their symptoms to be worse. Conclusion Telephone follow-up consultations may be a potentially cost-effective alternative to face-to-face appointments when implemented in a Rheumatology Podiatry Department, and provide an alternative way of providing care, especially when capacity for face-to-face contact is limited. The potential cost saving and efficiency benefits of this service are likely to be enhanced when telephone consultations are pre-arranged with patients.

scholarly journals Spine Examination during COVID-19 Pandemic via Video Consultation

2021 ◽  
Author(s):  
Tom Jansen ◽  
Martin Gathen ◽  
Amadeo Touet ◽  
Hans Goost ◽  
Dieter Christian Wirtz ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Range Of Motion ◽  
Test Results ◽  
Risk Of Infection ◽  
Face To Face ◽  
Reliable Tool ◽  
Provocation Tests ◽  
Active Range Of Motion ◽  
Video Consultation ◽  
Good Agreement

Abstract Introduction During the current COVID-19 pandemic video consultations are increasingly common in order to minimize the risk of infection for staff and patients. The aim of this study was to evaluate the feasibility of a spine examination via video. Methods A total of 43 patients were recruited. Each participant underwent a video-based (VB) and a conventional face-to-face (FTF) spine examination. Pain intensity, active range of motion, inspection, a neurophysiologic basic exam and provocations tests were evaluated using video-based and face-to-face methods. Results The intra-rater reliability (IRR) was measured between both examinations. Good to very good IRR values were obtained in inspection (Kappa between 0,752 und 0,944), active range of motion and basic neurophysiological examination (Kappa between 0,659 und 0,969). Only moderate matches were found in specific provocation tests (Kappa between 0,407 und 0,938). A video-based spine examination is a reliable tool for measuring pain intensity, active range of motion and a basic neurophysiologic exam. Conclusion A basic spine examination during a video consultation is possible. A good agreement of the test results between video-based and face-to-face examination could be found.

scholarly journals Are telephone consultations here to stay in rheumatology?

2020 ◽  
Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham
Keyword(s):  
Older Patients ◽  
Online Survey ◽  
Vulnerable Groups ◽  
Age Group ◽  
Telephone Consultation ◽  
Survey Tool ◽  
Face To Face ◽  
Vulnerable Patients ◽  
Number Of Patients

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.

scholarly journals COVD-26. TELEPHONE CONSULTATIONS IN NEURO-ONCOLOGY DURING THE COVID-19 PANDEMIC: LEVELS OF PATIENT SATISFACTION AND COMPARISON WITH TRADITIONAL FACE-TO-FACE CONSULTATIONS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii26-ii26
Author(s):  
Emma Toman ◽  
Claire Goddard ◽  
Frederick Berki ◽  
William Garratt ◽  
Teresa Scott ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
University Hospitals ◽  
Health Crisis ◽  
Patient Satisfaction Questionnaire ◽  
Telephone Consultation ◽  
Exact Test ◽  
Face To Face ◽  
Significant Difference ◽  
The Face ◽  
The University

Abstract INTRODUCTION Controversy exists as to whether telephone clinics are appropriate in neurosurgical-oncology. The COVID-19 pandemic forced neuro-oncology services worldwide to re-design and at the University Hospitals Birmingham UK, telephone clinics were quickly implemented in select patients to limit numbers of patients attending hospital. It was important to determine how these changes were perceived by patients. METHODS A 20-question patient satisfaction questionnaire was distributed to patients who attended neuro-oncology clinic in person (“face-to-face”), or via the telephone. Fisher’s exact test was used to determine significance, which was set at p< 0.05. RESULTS Eighty questionnaires were distributed between June 2020 and August 2020. Overall, 50% (n=40) of patients returned the questionnaire, 50% (n=23) of face-to-face and 50% (n=17) telephone patients. Of those who received telephone consultations, 88% (n=15) felt the consultation was convenient, 88% (n=15) were satisfied with their consultation and 18% (n=3) felt they would have preferred to have a face-to-face appointment. Of those who attended clinic in person, 96% (n=22) felt their consultation was convenient, 100% (n=23) were satisfied with their consultation and 13% (n=3) would have preferred a telephone consultation. Within the face-to-face clinic attendees, only 13% (n=3) were concerned regarding the COVID risk associated with attending hospital. There was no significant difference in patient convenience or satisfaction (p=0.565 and p=0.174 respectively) between face-to-face and telephone clinics. There was no significant difference in whether patients would’ve preferred the alternative method of consultation (p > 0.999). CONCLUSION Our study suggests that careful patient selection for neuro-oncology telephone clinic is not inferior to face-to-face clinic. Telephone clinic during COVID-19 pandemic proved to be convenient, safe and effective. This global health crisis has transformed telephone neuro-oncology consultations from an experimental innovation into established practice and should be continued beyond the pandemic in select cases.

Sign in / Sign up

Export Citation Format

Share Document