Telehealth in the Post Pandemic Era

As we look towards post-pandemic health delivery, the role of telehealth must be examined. We use the RE-AIM framework to discuss the challenges and successes of telehealth during the pandemic in the United States, and propose critical aspects to consider for optimizing telehealth care in the future.

What is evidence as evidence is used? A case of dualism?

How ‘evidence’ is conceptualised, generated and deployed in meso-level policy implementation on the ground is critical to health delivery. Using the case of a large-scale health service reconfiguration in northwest England, this study began as a narrative investigation into how different data types and sources are prioritised as NHS administrative structures change over time. During the research, one unpopular reconfiguration decision, the downgrading of a hospital, was challenged using judicial review. Suddenly, a key decision was being based not upon ‘facts and data’ type evidence but upon evidence of adherence to administrative procedure. This transferred focus away from the ever-shifting categories and hierarchies of data ‘types’ towards an emphasis on process. By comparing two deliberative contexts—committee and judicial review—this article proposes that evidence can be understood as simultaneously entity and process. As health service reconfigurations continue in response to austerity, integration agendas, evolving organisational landscapes, and demographic and political change, it is increasingly important to recognise the different meanings and uses of evidence.

Remote-Delivered Services on College Campuses Manuscript

Objective: The COVID-19 pandemic has drastically increased use of remote-delivered mental health services. This study identifies advantages and limitations of remote-delivered services on college campuses to inform mental health delivery post-pandemic. Methods: Clinicians (n = 30) were asked to evaluate COVID-19’s impact on their work, environment, and wellness in an online survey. Qualitative data was coded using a thematic analysis approach, while quantitative data was analyzed using descriptive statistics. Results: Many clinicians reported benefits of remote services, including increased accessibility, greater convenience, no change in therapeutic alliance, and decreased stress for clinicians. Clinicians also experienced challenges such as social isolation, technological difficulties, and personal/family concerns. Clinicians envisioned a hybrid service combining online and in-person activities post-pandemic. Conclusions: Overall, remote-delivered mental health services on college campuses have potential in increasing treatment quality while highlighting a necessity for further research in hybrid mental health delivery.

Role of Telemedicine in Guiding Rural Emergent Neurosurgical Care

Teleneurosurgery can play a vital role in the care of patients in hospitals and community health settings where neurosurgical expertise is not available. The combination of audiovisual interaction of a neurosurgeon with the emergency physician, the patient and the patient’s family, combined with an intense education program delivered to the originating site care team, has greatly enhanced the appropriate triage of patients in community hospitals. The result is better patient care, improved patient and family satisfaction, cost savings, and the retention of patients within the local community care system, as well as the improved sustainability of the wider health delivery system. To succeed, start-up financial support is often needed to provide the required technical elements and 24/7 neurosurgical availability.

An Introduction to Global Health Delivery

What has called so many young people to the field of global health is the passion to be a force for change, to work on the positive side of globalization, and to be part of a movement for human rights. This passion stems from the knowledge that the world is not OK. Impoverished people are suffering and dying from treatable diseases, while the wealthy live well into their 80s and 90s. These disparities exist between and within countries. COVID-19 has further demonstrated the need for global equity and our mutual interdependence. Yet the road to health equity is long. People living in countries and communities marred by slavery, colonialism, resource extraction, and neoliberal market policies have markedly less access to health care than the wealthy. Developing equitable health systems requires understanding the history and political economy of communities and countries and working to adequately resource health delivery. Equitable health care also requires strong advocacy for the right to health. In fact, the current era in global health was sparked by advocacy—the activist movement for AIDS treatment access, for the universality of the right to health and to a share of scientific advancement. The same advocacy is needed now as vaccines and treatments are developed for COVID-19. This book centers global health in principles of equity and social justice and positions global health as a field to fulfill the universal right to health.

Monitoring, Evaluation, and Quality Improvement in Global Health

Quality data are necessary to make good decisions in health delivery, for both individuals and populations. Data can be used to improve care and achieve equity. However, the collection of health data has been weak in most impoverished countries, where health data are compiled in stacks of poorly organized paper records. Efforts to streamline and improve health information discussed in this chapter include patient-held booklets, demographic health surveys, and the use of common indicators. This chapter also focuses on the evolution of medical records, including electronic systems. The use of data for monitoring, evaluation, and quality improvement is explained. Finally, this chapter reviews the use of frameworks—such as logic models and log frames—for program planning, evaluation, and improvement.