cord-029848-dj5xqlz1	2020	Telemedicine is defined as the delivery of health care services, where distance is a critical factor, by all healthcare professionals using information or communication technology. Telemedicine aims to ensure equitable services to everyone, is costeffective, provides safety to both patient and doctors during pandemics, and offers timely and faster care. Telemedicine can be classified on the basis of mode of communication as (i) audio, video or text-based (video mode is preferred as it allows limited examination as well); (ii) timing of information transmitted as real time or asynchronous exchange; (iii) purpose of consult as first time or follow up (in non-emergent cases or emergency consultation); and (iv) according to individuals involved as patient to medical practitioner, caregiver to medical practitioner, medical practitioner to medical practitioner or health worker to medical practitioner [2] . Doctors should avoid giving advice in such cases and the patient must be referred for an urgent in-person visit to the nearest hospital.
cord-104485-3anla664	2020	The objective of this study was to evaluate the feasibility and acceptability of group visit provider encounters conducted via telemedicine while CHWs led the educational sections in-person for a low-income, Latino(a) population. We conducted a prospective, feasibility and acceptability study of provider-patient telemedicine encounters in diabetes group visits at a 501(c)(3) community clinic that serves low-income (≤250% federal poverty level), uninsured individuals in Houston, Texas. We also evaluated eight focal areas of feasibility: acceptability (how participates reacted to telemedicine), adaptation (changing program (if applicable)), demand for intervention (attendance), expansion (potential success within a different population or setting), limitedefficacy testing (i.e., TUQ, clinical outcomes), implementation (likelihood telemedicine could be conducted as proposed), integration (level of change needed to initiate telemedicine), and practicality (extent telemedicine could be delivered) [21] . This study evaluated patient-provider telemedicine encounters during group visits and found that they were feasible and acceptable as evidenced by systematic positive findings on the TUQ and no negative clinical impact during the virtual months.
cord-254040-s3k51rkk	2020	In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk to be lost at follow-up, leading to a higher risk of morbidity and mortality. In this context, patients affected by chronic neurological diseases, such as amyotrophic lateral sclerosis (ALS), are at risk of being lost at follow-up with a consequently higher morbidity and mortality. Neurological examination and ALS Functional Rating Scale revised (ALSFRSr) are the most important tools to monitor disease progression. In a recent randomized trial comparing remote nutritional counseling with or without mobile health technology in ALS patients, Nu Planit application was an acceptable and useful mobile app to check nutritional status [17] . In conclusion, implementing telemedicine services for patients with ALS is necessary to allow direct clinical evaluation during COVID-19 pandemic, in order to plan the appropriate medical and nursing care, avoiding hospitalizations or urgent interventions. Telemedicine for patients with amyotrophic lateral sclerosis during COVID-19 pandemic: an Italian ALS referral center experience
cord-257229-5ml5ceu0	2020	We aimed to compare travel burden, visit time, and patient satisfaction between an initial postoperative telemedicine visit and a second conventional in-clinic visit. METHODS: Telemedicine guidelines established by our hospital system were used as inclusion criteria for this prospective study, which included patients indicated for surgery in the outpatient clinic during a 3-month period. CONCLUSIONS: A telemedicine program for postoperative care after hand and upper extremity surgery decreases travel burdens associated with conventional in-clinic appointments. CLINICAL RELEVANCE: Telemedicine after hand and upper extremity surgery results in high levels of patient satisfaction and decreases visit times and the travel burdens associated with conventional in-clinic appointments. We aimed to compare travel burden, visit time, patient satisfaction, and ease of use between an initial postoperative telemedicine visit and the second conventional inclinic visit. A telemedicine program for postoperative care after hand and upper extremity surgery decreases travel burdens associated with conventional in-clinic appointments.
cord-259395-ytj21cit	2020	the pandemic, we already lived times of overwhelmed consultations with financial constraints, and the promise of telemedicine for improving access to better health services at lower costs drew attention to its use. Moreover, the efficacy of telemedicine on health outcomes is inconsistent across different programs used in inflammatory bowel disease (IBD), and their value is difficult to establish when only few economic data are available. In a previous pilot trial, TECCU showed to be a safe strategy to improve health outcomes of complex IBD patients [3] , with a high probability of being more cost-effective in the short term compared to standard care and telephone care [4] . Maybe the pandemic has reduced reluctance amongst physicians to use telemedicine, but funders, policy-makers, providers and patients need to align their interests to implement remote healthcare successfully. In spite of the use of telephone and e-mail in many centers, the development of mature telemedicine programs integrated with electronic health records requires further collaborative efforts between different investigators.
cord-265934-wjdxqj8h	2020	21 Recent studies on remote free flap monitoring provide clear examples of how telemedicine can not only expedite care, but also improve patient outcomes. There is a further need for controlled studies comparing telemedicine to in-person assessment of head and neck cancer patients in terms of cost, safety, surveillance adherence, and oncologic outcomes. published clinical practice guidelines for the management of dysphagia in the COVID-19 pandemic, suggesting use of telemedicine for triage and remote evaluation. 63 High levels of patient satisfaction were also achieved with smartphone-based follow-up of facial cosmetic surgery and reviewing images remotely. Telemedicine has a wide applicability in pediatric ORL for obtaining patient history and assessing need for common surgeries such as obstructive sleep apnea, recurrent tonsillitis, and recurrent otitis media (Table VII) . Utilization of SAF techniques have already proven useful in head and neck oncology consultations, remote otologic and audiologic evaluation, cochlear implant and hearing aid management, laryngeal ultrasonography, nasolaryngoscopy, as well as CT sinus review.
cord-266371-eynmgvbd	2020	
cord-267400-3mrqiofw	2020	Among children cared for by telemedicine-using and non-using subspecialists, we compared visit rates across child characteristics by assessing negative binomial regression interaction terms. Compared to children receiving care from telemedicine non-using subspecialists, matched children receiving care from telemedicine-using subspecialists had larger differences in visit rates by distance to care, county rurality, ZIP code median income, and child race/ethnicity (p<0.001 for interaction terms). We matched on child age group, gender, race, Medicaid eligibility category and plan type, ZIP code median income level, county rurality, distance to care, months enrolled, subspecialist characteristics, and state. Compared to children receiving care from telemedicine non-using subspecialists, matched children receiving care from telemedicine-using subspecialists had larger variation in incident rate ratios by distance to care, county rurality, ZIP code median income, and child race/ethnicity (p<0.001 for each interaction term). In conclusion, we found low use of telemedicine among subspecialists caring for pediatric Medicaid beneficiaries in 2014, but increased likelihood of telemedicine use among children in rural communities and at distance to subspecialty care.
cord-270153-krhkqcev	2020	
cord-271573-qsr3ka5p	2020	In a 2008 study, Smith and colleagues 5 attempted to determine concordance between pediatric otolaryngology diagnoses and surgical management plans made via a live videoconference and a subsequent, in-office consultation. 11, 12, 14 More recently, Gupta and colleagues 7 published a study in 2020 that examined the feasibility of equipping trained health workers with a store and forward telemedicine device to triage underserved otology patients in India. While much of the literature focuses on store and forward telemedicine in the context of providing care to remote or underserved populations, its benefits should be considered by all ENT practices during the COVID-19 era, as advances in technology have improved its cost effectiveness and convenience. Both of these studies indicate that smartphone otoscopy can be performed by parents; however, the diagnostic reliability of the captured media must improve for this technology to be widely implemented.
cord-281796-sutgyaep	2020	The COVID-19 pandemic has necessitated increased use of telemedicine for diagnosis and management of musculoskeletal disorders. J o u r n a l P r e -p r o o f Summary The COVID-19 pandemic has necessitated increased use of telemedicine for diagnosis and management of musculoskeletal disorders. We describe the initial virtual/telemedicine encounter and management of a patient with knee pain initially diagnosed as gonarthrosis but that actually resulted from an impending pathologic fracture of the femur. We describe the initial virtual/telemedicine encounter and management of a patient with knee pain initially diagnosed as gonarthrosis but that actually resulted from an impending pathologic fracture of the femur. One obvious drawback to using telemedicine visits is the limitation placed in conducting a physical examination. Physical examinations through the video component of eVisits are also limited, albeit less so than with telephonic encounters. Some locales have services that provide mobile imaging at the home of the patient.
cord-282730-pawasfh4	2020	RESULTS: At many institutions, the number of telemedicine visits dramatically increased within days following the institution of novel coronavirus pandemic restrictions on in-person clinical encounters. To minimize interruption of crucial clinical services and the associated revenue, a rapid transition from in-person outpatient visits to telemedicine encounters was implemented by many academic medical centers and adopted by surgery departments throughout the country. The Centers for Medicare and Medicaid Services (CMS) sought to decrease in-person medical visits by issuing a temporary and emergency relaxation of telemedicine rules via the 1135 waiver and the Coronavirus Preparedness and Response Supplemental Appropriations Act. Enacted on March 6, 2020, this act allowed Original Medicare enrollees the same telemedicine benefits that had been extended to Medicare Advantage enrollees in January 2020. In addition, on March 13, 2020 the FCC funded the Rural Health Care Program that aims to make telemedicine services available to geographically remote patients.
cord-285277-8w03car3	2020	
cord-287350-xj2i6fgd	2020	
cord-294487-hcuzxhb3	2020	The current COVID 19 global pandemic has forced a paradigm shift with many centers rapidly adopting virtual visits to conduct care resulting in rapid expansion of use of telemedicine amongst practices. BODY: This commentary discusses practical tips for physicians including guidance around administrative and governance issues, preparation for telemedicine, involving the multidisciplinary care team, and teaching considerations. CONCLUSION: This commentary provides a starting framework for telemedicine use in pediatric rheumatology and further work on validation and acceptability is needed. Virtual care models with remote clinics and video visits (e-visits or telemedicine) have become widespread practice overnight. This commentary describes practical creative approaches based on our experiences and discusses the potential for telemedicine to address unmet needs in the wider context of pediatric rheumatology. Young patients (< 3 years) are more challenging to keep on task with a virtual joint exam, but a care-giver only visit to discuss symptoms or medication side effects is often feasible. Decreasing patient cost and travel time through pediatric rheumatology telemedicine visits
cord-300620-scauefiv	2020	
cord-301083-nnh95i0k	2020	
cord-306293-miyc5kok	2020	During the COVID-19 pandemic, among 55 of the 73 original responding programs (75%) from all 11 OPTN regions, telemedicine use increased from 16% to 98% and was used throughout all phases of transplant care. We conducted a national survey of all liver and intestinal adult and pediatric transplant programs active in 2018 in UNOS to assess practice patterns of in-person outreach clinics and telemedicine from January to March 2019. We assessed the use of outreach clinics as well as live video and asynchronous telemedicine (e.g. electronic consultation by review of medical records or imaging studies), including the frequency of telemedicine, duration of use, phase of transplant care in which it was used, providing care across state lines, and reimbursement. Given high clinical demands during the COVID-19 pandemic, our follow-up survey asked targeted questions limited to: 1) use of synchronous telemedicine modality (live video, telephone, both), 2) type of provider using telemedicine, 3) phase of transplant care for which telemedicine was used.
cord-307808-0t6sw0zp	2020	To decrease transmission of SARS-CoV-2, the virus responsible for COVID-19, while maintaining health-care access, telehealth -particularly, virtual visits in place of traditional in-person visits -has expanded rapidly around the world. Telemedicine specifically addresses the diagnosis, treatment and monitoring of patients (including history taking and appropriate physical examination) by means of electronic technology. In the midst of these major changes, clinicians are still responsible for ensuring patients receive the care they need, as well as understand the limitations of telemedicine visits. However, we feel strongly that complex medical problems involving major decision-making, such as in follow-up of organ transplant recipients who are manifesting symptoms suggestive of infection or rejection, require in-person patient evaluation. Health-care providers should be prepared to interrupt digital visits or arrange timely follow-up as necessary, so that any patient identified as requiring in-person evaluation will be appropriately directed to receive timely medical attention.
cord-308873-73zv5ned	2020	To prepare clinical evidence in earlier telemedicine projects, various medical devices were used to check the patient''s condition and provide medical treatment through videotelephony [5] [6] [7] [8] . For this reason, it is true that the earlier telemedicine projects concentrated on medical devices and platforms to check health conditions of patient [9, 10] . Patients unfamiliar with telemedicine will be more interested in taking prescriptions for repeated medications without visiting the hospital, rather than using telemedicine for the purpose of healthcare. Unlike face-to-face medical treatment, which consists of inspection, palpitation, percussion, and auscultation, telemedicine consists only of inspection; hence, safety problems and accountability are inevitable (Currently, temporary telemedicine is a telephone consultation, without inspection. However, it is difficult to judge whether telemedicine should be adopted in the future based only on the experience of temporary telemedicine initiated during COVID-19.
cord-309074-pys4aa60	2020	
cord-310976-24b3c3a4	2020	We used time-driven activity-based costing to evaluate the change in resource use associated with transitioning to telemedicine in a radiation oncology department. CONCLUSIONS: A modified workflow incorporating telemedicine visits and work-from-home capability conferred savings to a department as well as significant time and costs to health care workers and patients alike. 5 In this study, using a patient undergoing a 28-fraction treatment course as an example, we used TDABC to evaluate the overall change in resource use associated with transitioning to telemedicine in a radiation oncology department. For each patient undergoing 28-fraction treatment, 6 OTVs, and 1 follow-up visit, transitioning to telemedicine workflow reduced provider costs by $586 compared with the traditional workflow (Table 1 )d comprising space/equipment ($347) and personnel ($239). Compared with a traditional workflow involving in-person visits, a modified workflow incorporating telemedicine visits and work-from-home capability confers provider savings of $586/patient, with number of OTVs and cost of nursing time as the most important model inputs in the specific amount saved.
cord-311000-abntwzuy	2020	
cord-312947-ppc4w23a	2020	authors: Spiess, Philippe E.; Greene, John; Keenan, Robert J.; Paculdo, David; Letson, G. title: Meeting the challenge of the 2019 novel coronavirus disease in patients with cancer This commentary proposes a simple 5‐part strategy plus rapidly expanded use of telemedicine to anticipate and deal with COVID‐19 and, by extension, future epidemics in patients with cancer. Cancer Month 0, 2020 restrictions on telemedicine use, clinical trials be put into place for evaluating telemedicine''s clinical effectiveness, overall costs of care, diagnostic accuracy, and real and perceived effects on patient confidentiality. With these regulatory changes, however, providers need to be reassured that these changes and future regulatory changes, such as eliminating the need to first conduct an in-person visit before telemedicine is used, will encourage expanded use of telemedicine among oncologists to reduce COVID-19 infections today and improve access to care tomorrow. Infection in cancer patients: a continuing association
cord-314028-sf8zt9r9	2020	From March 7 to May 3, during the lockdown phase, 61 requests of telemedicine consultation (28, 45.9%, males; mean age ± standard deviation, 4.69 ± 3.22 years) to the paediatric infectious disease specialist in the hospital by the primary care paediatricians were made. A total of 55 (90.2%) paediatric problems that without telemedicine support could have led the patient to the emergency room of the hospital were solved in the community: 30 (54.5%) children with fever of unknown origin, 20 (36.4%) with skin rash, 3 (5.5%) with suspected primary immunodeficiency and 2 (3.6%) with acrocyanosis. This experience shows that during the COVID-19 outbreak, the use of telemedicine for the management of paediatric infectious diseases permitted us to avoid hospital access J o u r n a l P r e -p r o o f in 90% of the cases, favouring reduction of the pressure on the hospitals. Our experience shows that telemedicine may be an easy and effective measure to solve many paediatric problems in the community during COVID-19 outbreak, reducing emergency room visits.
cord-316414-1dho7mmd	2020	
cord-321030-isc3p46t	2020	EVIDENCE SYNTHESIS: Telemedicine refers to the use of electronic information and telecommunications tools to provide remote clinical health care support. 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. As telemedicine has been used in previous epidemic outbreaks, it has rapidly been incorporated into solutions to manage COVID-19 patients and in several countries for continuation of specialty care such as urology.
cord-321594-x5wv9p7n	2020	Due to the technology requirement, our concern is that telemedicine 7 In a recently published article by Nouri et al, the authors found that, in a primary care practice managing chronic diseases, a significantly smaller proportion of the visits after scaled-up telemedicine implementation was observed for vulnerable patients: age 65+ years, non-English language preference, and those insured by Medicare or Medicaid. Using a self-administered survey, DeMartini et al reported a high level of digital technology access among parents in an urban pediatric primary care clinic setting with a high percentage of African American and Medicaid-insured families in a low socioeconomic area. To provide a sustainable level of telemedicine care beyond the COVID-19 pandemic era and well into the future, we need to be cognizant of the language barrier and consciously structure future encounters with increased staff support and longer allotted time and examine more efficient ways to provide digital education and translational services to this population.
cord-322394-b18fv3r3	2020	
cord-323273-q53wf6au	2020	These digital innovations include artificial intelligence (AI), 5th generation (5G) telecommunication networks and the Internet of Things (IoT), creating an inter-dependent ecosystem offering opportunities to develop new models of eye care addressing the challenges of COVID-19 and beyond. This article reviews how countries across the world have utilised these digital innovations to tackle diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, glaucoma, refractive error correction, cataract and other anterior segment disorders. Several advanced techniques that assess refractive error accurately have been 1432 developed, and Patients were found to be sufficiently motivated to report their symptoms at least 1598 once a month with a good correlation between the two dry eye questionnaires 1599 (r=0.67), underscoring the potential utility of a tele-health approach for monitoring telemedicine presents different challenges in comparison to screening.
cord-323625-co5j8wwd	2020	
cord-323980-rcyjthze	2020	
cord-330017-t14o7rua	2020	
cord-330545-jrmott3i	2020	
cord-333003-t1lo5jpv	2020	As some telemedicine and telecommunication support tools have been incorporated into the otolaryngology practice in response to safety and access demands, it is essential to review how these tools and services can help facilitate facial trauma evaluation during a time when clinical resources are limited. OBJECTIVE: To review applications of telemedicine for the evaluation of facial trauma to better direct utilization of these methods and technologies during times of limited access to clinical resources such as the COVID‐19 pandemic. Telemedicine may provide a potential useful tool in the evaluation and triage of facial injuries and patient engagement. 11 As technologies developed and internet access improved over the years, however, some physicians envisioned telemedicine''s practical potential for facilitating medical care, such as implementing tele-tools for consultation to the underserved, proctored surgery, treatment, education, and research. Two studies explored the potential for using telemedicine tools to engage the patient in participating in their own facial trauma evaluation and follow up.
cord-333123-pglsgi2f	2020	
cord-334719-zl5mhuth	2015	
cord-337338-7uj2r0gy	2020	
cord-343205-zjw4fbfd	2020	Due to the COVID-19 pandemic, the American College of Cardiology urgently updated its guidance on "Telehealth: Rapid Implementation for Your Cardiology Clinic, " in which it encouraged remote monitoring and virtual visits of patients with cardiac problems (16) . A program developed in Germany known as TRANSIT-stroke, in which rural hospitals established a telemedicine network, saw an improvement in patient outcomes as neurological assessment was made faster, treatments were issued within the required timeframe, and 24 h neurologist access was enabled (27) . The rapid move by various bodies, associations, and providers to use telemedicine in maintaining patient continuity while limiting COVID-19 risks of exposure to patients and healthcare workers will have a long-term impact well-beyond the current pandemic. Key Strategies for clinical management and improvement of healthcare services for cardiovascular disease and diabetes patients in the coronavirus (COVID-19) settings: recommendations from the REPROGRAM consortium
cord-344258-19zzumqf	2020	
cord-345809-tevi0sup	2020	
cord-345949-6aehkrsm	2020	
cord-354885-fkgr2o9i	2020