Health and healthcare disparities associated with the digital divide
By Esli Osmanlliu, Ramesh Johari, and David Scheinker
The prioritization of telehealth in response to the COVID-19 pandemic may accelerate progress to virtual integrated care at scale. However, disparities in healthcare and health outcomes may widen if telehealth is not accessible to the underserved communities that are most in need. Providers faced with practical constraints have already defaulted into a two-tiered system of telehealth: technology-driven, integrated care for those with the requisite resources; and phone-based, ad-hoc care, possibly less effective, for those without. Insights based on data from federal organizations offer a starting point for primary care providers to understand common structural barriers to telehealth access, identify interventions they can implement to increase equity in their virtual care practice, and advocate for their patients. 27 January, 2021. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/166083
Guidance for Treating Patients with Opioid Use Disorder (OUD) with Buprenorphine- Naloxone (B/N) in the COVID-19 Era via Telehealth: A Review of Previous Evidence, New COVID-19 OUD Treatment Guidelines, and a Case Report of their Application
Randi Sokol, Ankit Gupta, Sarah Powers, Liza Hoffman, and Julio Meza
In this case report of a telehealth company's response to the pandemic, the authors share lessons learned in treating patients with OUD during the COVID-19 pandemic that consider the evidence base, new COVID-19 related guidelines, and their application. Understanding the evidence and current COVID-19-related guidelines can help frontline primary care providers employ new approaches to support these patients by providing B/N in a safe way that minimizes COVID-19 exposure risk and maximizes recovery support. 8 June 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/155566
Transforming Clinical Workflow for Telemedicine Visits in the COVID-19 Pandemic
Sirisha Mohan, MD, Wilson Lin, Anjali Mahoney, MD, and Jehni Robinson MD
The Department of Family Medicine at Keck Medicine of USC has expanded its telehealth services to all providers across all clinical sessions and locations. Initial workflows developed for telemedicine visits fell short in capturing the documentation required for compliance, risk, and quality metrics. To address these needs, the workflow was redesigned to integrate receptionists, medical assistants, and providers. 29 May 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/155452
Remote Options for Medication Abortion: Improving Patient Care During and After the COVID-19 Crisis
Tara Stein, MD, MPH, Ian Lague, MS, Marji Gold, MD, and Jessica Beaman, MD, MPH
Medication abortion is an essential, time-sensitive service that is particularly well-suited to telemedicine provision, including in primary care settings. As primary care providers, the authors advocate for high-quality, low-risk abortion care for patients without point-of-care exams and labs. The discussion includes a detailed checklist for providing such remote-care medication abortion in a variety of settings. Such strategies will allow more clinicians to offer this essential care both during and after the COVID-19 crisis. 21 May 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/155399
Physical Distancing With Social Connectedness
David Bergman, MD; Christina Bethell, PhD, MPH, MBA; Narangerel Gombojav, MD, MSc, PhD; Sandra Hassink, MD, FAAP; and Kurt C. Stange, MD, PhD
Recognizing and supporting the many ways of investing in relationship has great potential to create a positive sea change in a health care system that currently feels fragmented and depersonalized to both patients and health care providers. The current COVID-19 pandemic is full of opportunity to use remote communication to develop healing human relationships. Accepted 24 March 2020; Published 11 May, 2020. DOI: 10.1370/afm.2538.
Out of Touch
Martina Ann Kelly, MB BCh BAO, MA, PhD, FRCGP, CCFP, and Gerard J.Gormley, MB BCh BAO MD FRCGP FHEA
Covid-19 has rapidly changed physician-patient interaction, from hands-on to hands-off medicine. In this essay, as two family physicians in different continents, we reflect on the meaning of touch in clinical practice and how virtual care is transforming this tacit aspect of patient care. Accepted 18 May 2020. In Press. Permanent URL: http://hdl.handle.net/2027.42/154740
Humanism in Telemedicine: Connecting Through Virtual Visits During the COVID-19 Pandemic
Megha Shankar, MD; Meredith Fischer, MA; Cati G. Brown-Johnson, PhD; Nadia Safaeinili, MPH; Marie C. Haverfield, PhD; Jonathan G. Shaw, MD, MS; Abraham Verghese, MD; and Donna M. Zulman, MD, MS
The COVID-19 pandemic is spurring the massive deployment of telemedicine to prevent risk of infection and address healthcare workforce demands. In primary care, many visits have shifted from in-person to telemedicine, introducing a potential barrier to the human connection that is central to clinical care. We adapted existing frameworks that seek to foster humanism in clinical care-the Four Habits Model and Presence 5-to the virtual care context. 13 April 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/154738