TP20. TP020 TELEHEALTH AND REMOTE MONITORING FOR PULMONARY, CRITICAL CARE, AND SLEEP最新文献

{"title":"\"It's Not that Intuitive for Somebody Who Doesn't Do This All Day Every Day:\" A Qualitative Study of VA Specialists' and Primary Care Providers' Perspectives Regarding E-Consult Requests","authors":"A. Krones, E. Anderson, V. Vimalananda, S. Rinne","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1723","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1723","url":null,"abstract":"","PeriodicalId":159700,"journal":{"name":"TP20. TP020 TELEHEALTH AND REMOTE MONITORING FOR PULMONARY, CRITICAL CARE, AND SLEEP","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114189089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing Social Support for Adults with Cystic Fibrosis During the COVID-19 Pandemic: Pilot Study of a Web-Based Support Group","authors":"M. Basile, K. Henthorne, A. Marziliano, J. Polo, K. Wong, D. Tsang, G. Lavecchia, T. Frantzen, N. Hajizadeh, J.Y. Wang","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1729","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1729","url":null,"abstract":"Introduction: Heightened anxiety and social isolation were experienced among our Northwell Health adult cystic fibrosis (CF) population during the first wave of the COVID-19 pandemic in New York. To mitigate this, clinical staff implemented a web-based support group. Herein, we compare pre/post psychosocial factors and knowledge among participants. Methods: Adults from Northwell Health's CF Clinic participated in a 10-session, CF social worker-moderated, live, web-based support group study comprised of 6 open and 4 topic-based sessions covering: pre-lung transplant preparation, anxiety/mental health, nutrition, and a presentation by a lung transplant team. Participants completed baseline surveys: demographics and needs assessment, baseline/final session: GAD-7(anxiety), PHQ-9(depression), UCLALS(UCLA Loneliness Scale), and COVID-19 Impact Scale, pre/post topic session knowledge tests, and a 1-time final assessment. Sessions were audio recorded and transcribed for content analysis. Results: Between May 14-September 24, 2020, 9 CF adults (6 female/3 male) participated. Average pre-support group needs assessment scores showed most participants believed there was greater need for support, education and social interaction for CF adults (12.77/total score 15). Baseline/final scores showed average improvement for anxiety, depression and COVID-19 impact - decreased scores: GAD-7 (7.33/7.11), PHQ-9 (8/6.11) and COVID-19 impact (16.44/15.55), but increased loneliness: UCLALS (20.22/23.33), perhaps due to the toll of long-term quarantine. Pre/post knowledge scores from topic sessions showed slightly increased average scores for pre-lung transplant preparation (3.25/3.75/total score 4), nutrition guidelines (3.66/4/total score 4), and lung transplant team presentation (3.00/3.34/total score 4), but no change in CF anxiety/mental health knowledge (3.25/3.25/total score 4). Post-support group evaluations showed participants found the support group beneficial (68.11 out of total score of 80). Content analysis revealed participants' anxiety from family/friends not taking seriously COVID-19 risks to people with CF, and isolation from feeling “left behind” as the wider society reopened during summer months. Participants shared different COVID- 19 coping strategies (e.g., viewing opera online, meditation apps, outdoor exercise). Participants were concerned about the pandemic's toll on the well-being of their non-CF family members who were practicing strict social distancing to protect the CF person. While some participants had prior social interactions with other CF individuals, other participants stated they rarely/never interacted with other CF people and, therefore, expressed positive sentiments about their support group experiences. Conclusions: Our CF adult support group provided opportunities for social interaction and CF-specific education during the first wave of the COVD-19 pandemic, resulting in decreased anxiety and depression, and increased knowledge ab","PeriodicalId":159700,"journal":{"name":"TP20. TP020 TELEHEALTH AND REMOTE MONITORING FOR PULMONARY, CRITICAL CARE, AND SLEEP","volume":"261 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115923841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Airway Disease Patients’ Challenges During a Virtual Study: Insights from Participants & Researchers","authors":"N. Tregobov, A. McMillan, Y. S. Chae, M. Mahjoob, B. Poureslami, J. Block, I. Poureslami, J. FitzGerald","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1720","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1720","url":null,"abstract":"Rationale: The COVID-19 pandemic has decreased the feasibility of in-person research. Despite this, widespread technological accessibility and ease-of-use make virtual research a viable alternative. Studies conducted virtually offer researchers and participants flexibility, convenience, and geographic accessibility. However, there are inherent challenges that may influence the research process, particularly for participants. This study examines patients' challenges with participating in a virtual research interview from the perspectives of researchers and patients. Methods: We conducted an exploratory community-based sub-study during a concurrent study to validate a function-based health literacy measurement tool (questionnaire) with chronic airway disease patients. Participants received and accessed study materials virtually and responded to the questionnaire over-the-phone;some participants were re-tested for questionnaire reproducibility. Initially, participants and researchers independently responded to 6 open-ended questions post-interview regarding challenges experienced during the study. Responses informed the development of a comprehensive, 18-question checklist addressing participant challenges. In subsequent interviews, research assistants administered the checklist, capturing quantitative data and verbatim quotes. Researchers' observation notes, recorded during each interview, and team teleconference notes were reviewed to provide researchers' perspectives on participant challenges. Thematic analysis of qualitative data was conducted using NVivo (QSR International, Version 12). Challenges were coded inductively and quantified on the basis of whether a researcher or patient had indicated a patient challenge, and cross-referenced with detailed observation notes. Quantitative analyses were conducted using R (R Core Team, 2019). Results: Initial interviews (n=185) and re-tests (n=110) were analysed. Quantified challenges were compared across self-reported gender, condition (asthma, chronic obstructive pulmonary disease (COPD) & asthma-COPD overlap (ACO)), education level, first language, age, ethnicity, disease duration, and previous disease-specific education. In 76% of interviews, participants experienced one or more challenges;31 unique challenges were identified. As an example, Table 1 contains the top 5 problems experienced by participants, across disease and self-reported gender, during initial interviews recorded using the open-ended question set. Qualitative analysis revealed that participants primarily experienced challenges with technology, communication (verbal & online), and instruction clarity (e.g., when/how to use study materials). Conclusions: Participants experienced a variety of challenges throughout the virtual study. Considering potential friction points for participants and possible solutions prior to starting the study by involving researchers, key informants, and participants can enhance the study process. Developing","PeriodicalId":159700,"journal":{"name":"TP20. TP020 TELEHEALTH AND REMOTE MONITORING FOR PULMONARY, CRITICAL CARE, AND SLEEP","volume":"2004 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128747637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Smartphones and Tablets for Video Visits Between Patients and Families During the Height of COVID-19 in New York City","authors":"E. Tay, C. Kuhner, M. Lalane, A. Kopelman","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1726","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1726","url":null,"abstract":"Rationale: In March of 2020, New York City became an epicenter of COVID-19. Due to the risk of airborne transmission and limited personal protective equipment, hospitals restricted patient visitations to protect both healthcare workers and patients. In response to the initiation of this visitation restriction at our hospital on March 18, 2020, we piloted a video-based communication program for families to virtually “visit” their family members in the hospital. This is a quality improvement project designed to evaluate the utility and limitations of these virtual family visits during the pandemic. Methods: A retrospective chart review was conducted of all patients over 17 years-old hospitalized between March 18 and May 31, 2020 for documented video encounters performed by hospital staff at a New York City public hospital. All video calls were performed using Whatsapp, Facetime, or Google Hangout communication app on a hospital-issued smartphone or tablet. Data collected included date of call, patient age, call facilitator, preferred language, patient location during hospitalization, use of mechanical equipment for assisted breathing, hospital length of stay, patient disposition, discharge diagnosis, and any additional limitations noted by the staff during video visits. Patients admitted to the psychiatric, rehabilitation, pediatric, labor and delivery, forensics wards, or if only a voice call was performed, were excluded. Results: Of the 2068 hospitalizations qualified for chart review, 177 patients have thus far been identified with documented video visits. A total of 1416 video visits were performed in these patients. 71.0% of the patients were intubated during their hospitalization and when video visits occurred. 37.3% of the patients expired, while 24.9% were discharged home or to a short-term rehabilitation center (38.9%). The average length of stay was 35.2 days (SD 2.1). Majority of the diagnoses were COVID-related illnesses (61.0%). Social workers conducted 78.5% of the video visits, followed by physicians (57.7%) and hospital chaplains (9.6%). Average patient age was 62 years-old. Chart review process is currently ongoing. Conclusions: The use of smartphones and tablets for video visits facilitated communication between patients and their families when in-person visits were restricted. We were able to provide visual visits to families when patients were intubated and were unable to verbalize. While a significant number of patients expired during this period, families were able to “see” and communicate with their family members prior to their deaths. The use of this technology is an invaluable tool for families to communicate and partake in patient care. .","PeriodicalId":159700,"journal":{"name":"TP20. TP020 TELEHEALTH AND REMOTE MONITORING FOR PULMONARY, CRITICAL CARE, AND SLEEP","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125985395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video Telehealth Increased During COVID-19 Pandemic Among VA Pulmonary Clinics, but Barriers Remain to Reaching Similar Levels of Use as Primary Care and Among High Risk Groups","authors":"M. Griffith, L. Donovan, L. Kelley","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1730","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1730","url":null,"abstract":"RationaleThe COVID-19 pandemic has shifted care away from face to face encounters towards telephone and video telehealth. To accommodate this, the VA prioritized use of VA Video Connect (VVC) a software platform that connects providers with patients on their personal devices. As there may be factors particular to pulmonary or other specialty care clinics that are barriers or facilitators of VVC use, we wished to describe uptake of VVC in pulmonary clinics relative to a comparable specialty (cardiology) and primary care. We also sought to evaluate whether appropriate high-risk patient groups were being prioritized for VVC (e.g rural Veterans with limited access to VA services and older Veterans) to inform program development to facilitate wider expansion of this technology. MethodsWe collected data from the Veteran Health Administration Support Service Center (VSSC). We identified all encounters associated with a Pulmonary/Chest clinic location, Cardiology clinic, and Primary Care clinic. Among those encounters we identified all scheduled as VVC and sliced data by standard VA definitions of rurality. We compared use of VVC, as a proportion of total encounters, in September 2019 and September 2020 at the end of each fiscal year. As this study was hypothesis generating, we did not perform statistical testing though anticipate all differences would have been significant. Results We found that 0.02% of cardiology, 0.2% of pulmonary and 0.3% of primary care visits were conducted using VVC in 2019 and had increased to 6%, 6% and 14% respectively in 2020 (Table 1). During the pandemic, Veterans living in rural areas and highly rural were approximately half and one-quarter as likely to have a VVC encounter with a specialty clinic (cardiology or pulmonary) as Veterans in urban areas, respectively. Use of VVC was higher in primary care than specialty care clinics across rurality groups. Although use increased substantially across all age groups between 2019-20, it decreased with increasing age group across all three clinic types - with Veterans 85+y approximately half as likely to use VVC as Veterans 45-64y in both primary and specialty care. ConclusionsPrimary care use of video telehealth was higher than in specialty care clinics, potentially due to concerns about ability to examine and appropriately triage patients. Groups with limited access to hospital beds and at higher risk of severe complications of COVID infection were less likely to use VVC, suggesting targeted efforts are necessary to improve VVC use among high risk groups. .","PeriodicalId":159700,"journal":{"name":"TP20. TP020 TELEHEALTH AND REMOTE MONITORING FOR PULMONARY, CRITICAL CARE, AND SLEEP","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124195017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FEV1/FVC but Not PEF Predicts Exacerbation Events in Daily Home Spirometry - a Pilot Study","authors":"M. Soliński, L. Koltowski, M. Lepek","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1724","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1724","url":null,"abstract":"","PeriodicalId":159700,"journal":{"name":"TP20. TP020 TELEHEALTH AND REMOTE MONITORING FOR PULMONARY, CRITICAL CARE, AND SLEEP","volume":"445 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134004988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cost Analysis of Implementing Mobile-Health Facilitated Tuberculosis Contact Investigation in a Low Income Setting","authors":"P. Turimumahoro, A. Tucker, A. Meyer, R. Tampi, D. Babirye, E. Ochom, J. Ggita, I. Ayakaka, S. Hojoon, A. Katamba, D. David, J.L. Davis","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1722","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1722","url":null,"abstract":"","PeriodicalId":159700,"journal":{"name":"TP20. TP020 TELEHEALTH AND REMOTE MONITORING FOR PULMONARY, CRITICAL CARE, AND SLEEP","volume":"6 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134033978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}