Section on Telehealth Care Program最新文献_第2页

7 Year Old Male With 2 Months Of Progressive Left Sided Weakness 7岁男性，2个月进行性左侧虚弱

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.956

Ashley J. Van Putten, Sridhi M. Patel, A. Ward, Hannah L. Winters

引用次数: 0

Rapid Adoption of Telehealth Due to the COVID-19 Pandemic in A Large Urban Federally Qualified Health Center – Adapting the Pediatric Model to Care for Patients in Need 由于COVID-19大流行，在大型城市联邦合格医疗中心迅速采用远程医疗-调整儿科模式以照顾有需要的患者

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.977

S. Naureckas, Josie Llaneza, T. Schuh, Angkana Roy, Dhanya P. Limaye

{"title":"Rapid Adoption of Telehealth Due to the COVID-19 Pandemic in A Large Urban Federally Qualified Health Center – Adapting the Pediatric Model to Care for Patients in Need","authors":"S. Naureckas, Josie Llaneza, T. Schuh, Angkana Roy, Dhanya P. Limaye","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.977","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.977","url":null,"abstract":"Background/Program Goals: The COVID-19 pandemic has led to a signicant decline in the numbers ofambulatory healthcare visits in the US, with pediatricians seeing 62% fewer patients during the rst week inApril than the rst week in March (Adult/OB outpatient visits have declined 45-50% ) Nationwide, during April2020, it is estimated that approximately 30% of ambulatory visits were carried out via telehealth Inner-citychildren in Chicago live in families that are disproportionately impacted by the COVID-19 pandemic OurChicago-land Federally Qualied Health Center (FQHC), which serves over 80,000 patients and at baselineprovided over 6,000 weekly in-person visits (patient panel is 47% children/adolescents, > 90% low income, 71%Hispanic/Latino) is markedly changing our care model, including a rapid shift to telehealth, in order tomaintain needed services for our patients The services provided by our FQHC pediatricians are also changingin order to meet our FQHC's patient's needs during this time Evaluation: review of PDSA cycles, qualitative/quantitative feedback from staff and patients/families, clinical quality data Discussion: (1) Frommid-March to mid-April 2020, visit volume at our FQHC initially fell by 75% but now is approximately 85% ofpre-COVID volume No medical and only a few behavioral health visits were by telehealth prior to March Wewill describe how we used a plan-do-study-act (PDSA) approach to change our care delivery model so that 75%of visits are now being delivered partially or completely via telehealth (2) In the same period, our FQHC saw ashift in the age of patients accessing our call center with 2/3 of the requests for healthcare now from patientsover age 18 (before COVID-19, over half of all calls were for patients under age 18) Pediatricians at our FQHCnow provide telehealth visits for patients through age 25 (with structured support in place from ouradult/family medicine colleagues and informal continuing medical education on young adult topics as needed)in order to meet current patient demand (3) Targeted outreach to patients under age 2 for vaccinations, andfor all ages with special health care needs or chronic illness (including asthma), has been a successfulapproach to maintaining ambulatory/telehealth visit volume for pediatricians (4) All telehealth visits include aone-question social needs assessment screener Approximately 40% of patients screen positive and are beinglinked with appropriate resources in their communities by FQHC staff (5) As an FQHC, we report qualitymetrics including pediatric immunization rates, nutrition/activity counseling and adolescent depressionscreening These measures are being successfully addressed in our new telehealth model (6) A remotebehavioral health “warm hand-off” model is now in place for telehealth visits (7) Patient and staff satisfactionwill be presented Initial data show that patient satisfaction is high","PeriodicalId":321596,"journal":{"name":"Section on Telehealth Care Program","volume":"137 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129883010","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}

引用次数: 0

A Multicenter Telemedicine Handoff Pilot to Improve the Transition of Care from NICU to PCPs and Families 一个多中心远程医疗切换试点，以改善从新生儿重症监护室到pcp和家庭的护理过渡

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.959

Hadley S Sauers-Ford, J. Zenge, John Chuo, C. Olson, S. Ziniel, Kristin Hoffman

引用次数: 3

Program Evaluation: A Primary Care Clinic’s Transition During COVID-19 项目评估:一家初级保健诊所在COVID-19期间的转型

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.975

Kristen Johnson, C. Ulen, Jennifer A. Jenks

{"title":"Program Evaluation: A Primary Care Clinic’s Transition During COVID-19","authors":"Kristen Johnson, C. Ulen, Jennifer A. Jenks","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.975","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.975","url":null,"abstract":"Background The COVID-19 pandemic has shifted the nature of medical care in pediatric primary care Tomitigate transmission SARS-COV-2 and to preserve the supply of personal protective equipment, CDCguidelines advise limiting non-essential medical visits However, administering vaccinations, facilitatingdevelopmental screening, managing acute medical illness, and identifying and treating mental illness remainof paramount importance to the health of children Objectives This program evaluation explores how a singleprivate primary care clinic shifted over the course of a few weeks from standard on-site ambulatory care to apredominantly telemedicine-based format, with specic protocols for in-person sick visits and well child care(WCC) for infants and toddlers Methods A descriptive survey was undertaken of practice changes occurring ina single, private pediatric primary care clinic during the COVID-19 pandemic Regulatory changes, paymentpolicy updates, and ethical considerations guided decisions about the utilization of telehealth Infants sixmonths and under continued to undergo routine on-site WCC Families of children 9-18 months old were offered a choice of either hybrid telemedicine interviews followed by open-air exam and vaccinationconducted in the clinic parking lot, versus routine on-site WCC Families of children 2 years and older wereoffered telehealth WCC with on-site exam and vaccination scheduled for 3-4 months ahead All sick visits wereinitiated via telehealth, with open-air exam and testing performed if deemed indicated by the provider Weeklyvisit number, percentage of well child checks, percentage of acute sick visits, and percentage of mental healthvisits were assessed through the clinic's electronic medical record Results Advanced Pediatrics (AP) is aprivate, suburban pediatric primary care clinic AP serves approximately 8,000 patients from birth through age22 years and averages 2000 patient visits per month In the month prior to the COVID-19 pandemic, >99% ofvisits were on-site;28% percent of visits were for WCC, 65% percent for acute illness, and 7% percent formental health In the month following the implementation of the COVID-19 telemedicine strategy, the totalnumber of visits decreased by 45% Telemedicine comprised 82% of visits WCC accounted 37% of visits, acutemedical care 55%, and mental health 8% of visits At the time of submission, the number and proportion ofvisits that were WCC as compared to acute medical care visits appeared to be increasing each week Conclusion Utilizing existing technologies and adapting to rapid changes in regulatory and billing policies, asingle private practice shifted the provision of pediatric care to a predominantly telemedicine based format,with specic protocols for in-person visits for well and sick children By sharing lessons learned from thisexperience, pediatricians may craft universal procedures that can be mobilized in case of future interruptionsto the standard model of medical care Impact","PeriodicalId":321596,"journal":{"name":"Section on Telehealth Care Program","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116230681","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}

引用次数: 0

Increasing Diagnostic Services for Autism Spectrum Disorder in the Native American Community: A Pilot Collaborative Telecare Model 增加对美国原住民社区自闭症谱系障碍的诊断服务:试点协作远程医疗模式

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.970

Amanda E. Bennett, Margaret P. Ray, Eric Zucker, John Chuo

引用次数: 0

Hybrid Well Child Visits in the Age of Covid: How To Balance Shelter in Place with Primary Care? 新冠肺炎时代的混合井儿童访问:如何平衡住所与初级保健?

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.965

D. Francis, K. Kang, Shannon Marrero, L. Shaw

{"title":"Hybrid Well Child Visits in the Age of Covid: How To Balance Shelter in Place with Primary Care?","authors":"D. Francis, K. Kang, Shannon Marrero, L. Shaw","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.965","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.965","url":null,"abstract":"The covid-19 pandemic has forced us to reevaluate how we deliver care to our patients How do we balanceShelter in Place orders with the need to provide well child care and vaccines? We work in an FQHC and serve alargely immigrant Hispanic community, many of our patients' parents are migrant and seasonal farmworkers We made many changes in our clinic to adapt to covid-19: an outdoor respiratory clinic and covid testing,telephone and telehealth visits to keep patients who are sick out of clinic, telephone outreach to addresssocial determinants of health (mainly food insecurity and housing), administering of free medications forthose uninsured patients who could no longer afford their medications Throughout these changes to addressimmediate needs, we limited our well child visits to 2 years and under to protect our patients, our staff andour limited clinic resources However, as we settled into this 'new normal', we quickly realized we needed arecovery plan to address the backlog of well child visits for all ages and vaccines that could be nimble enoughto withstand possibly repeated rounds of social distancing over the months to come That is how the hybrid clinic model came into fruition Our pediatrics team was committed to keeping our patients immunized and tosupport their growth and development during covid-19 We began reaching out to colleagues across the stateand country to nd out what others were doing, joined one of the AAP Covid-19 ECHO groups and researchingemerging best practices for how to deliver well child care during a pandemic We brought the model to ourCovid-19 incident command team and to our frontline medical providers for feedback and ideas Our currentwell child check model is in pilot stage and involves a combination of telephone and in person components We are learning and innovating how to best serve our patients As a Level 3 Patient Centered Medical Homeand a Federally Qualied Health Center, we already do quality improvement and quality assurance tracking onmany topics, including vaccines and well child visit adherence We will continue to use data to monitor oursuccess with this model and make adjustments along the way as needed The covid-19 pandemic is a globalchallenge affecting us all Technology, specically telephone and telehealth services have allowed us toinnovate quickly on how to deliver care-both acute and preventive- to vulnerable populations This time inhistory is highlighting the advances of hospital and ICU medicine to treat people suffering a new disease and,at the same time, it puts primary care into sharp focus as a critical safety net that must remain intact, evenduring a pandemic, to support our children An initial overview to train medical providers on how we will approach well child visits in clinic during shelter inplace orders related to covid-19 Summary of Well Child Visits Table depicting how telephone technology will be used to limit the amount oftime the patient is physically in clinic while attempting ","PeriodicalId":321596,"journal":{"name":"Section on Telehealth Care Program","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132874771","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}

引用次数: 1

Optimizing Teleneonatology Service Activation and Utilization through Simulation and Site Visits 通过模拟和实地考察优化远程生态学服务的激活和利用

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.972

Beth L. Kreofsky, Jennifer L. Fang

引用次数: 1

A Mixed Methods Evaluation of the Implementation of Asthma Care in Rural School-Based Telehealth Clinics 农村校本远程医疗诊所哮喘护理实施的混合方法评价

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.957

Claire A MacGeorge, A. Andrews, K. Sterba, Emily E Johnson, D. Brinton, R. Teufel, Kathryn C. Hale, R. Kruis, Kathryn King, D. Ford

引用次数: 1

Getting A Head Start on Asthma: A Preschool Based Telehealth Initiative 获得哮喘病的先机:一项基于学龄前儿童的远程医疗倡议

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.964

Deanna S. Richmond, Katherine Yanagisawa

引用次数: 0

Implementation Study: Challenges of Rapid Telemedicine Implementation into a Small Community Pediatric Allergy-Asthma Practice 实施研究:在小型社区儿科过敏哮喘实践中快速远程医疗实施的挑战

Section on Telehealth Care Program Pub Date : 2021-02-24 DOI: 10.1542/PEDS.147.3_MEETINGABSTRACT.969

J. Phillips, S. Saini

{"title":"Implementation Study: Challenges of Rapid Telemedicine Implementation into a Small Community Pediatric Allergy-Asthma Practice","authors":"J. Phillips, S. Saini","doi":"10.1542/PEDS.147.3_MEETINGABSTRACT.969","DOIUrl":"https://doi.org/10.1542/PEDS.147.3_MEETINGABSTRACT.969","url":null,"abstract":"Telemedicine is utilized in the United States, but its acceptance has been limited In the environment of apandemic, the healthcare industry is forced to alter the delivery of care to contain the virus' spread Utilizingtelemedicine in small community settings may ensure continuity of care and deliver healthcare advice whilereducing the risk of exposure Program Goals: review the challenges, benets, and limitations of rapidlyimplementing telemedicine into one small Pediatric Allergy practice in response to the COVID-19 pandemic Implementation resources included education via online webinars and online research Evaluation: Care wasdelivered by a physician and nurse practitioner via real-time audiovisual teleconference Platforms utilizedincluded Zoom and Doxy me Preparation included evaluating telemedicine platforms, staff training, andpatient education in the setting of quickly changing regulatory and nancial policies During the rst month oftelemedicine implementation, clinicians perceived several frustrations These included reviewing test results without parents possessing the test result copies Concerns of HIPAA privacy limited document sharing withfamilies Parents were also visualized writing their child's results which may have impaired their ability toabsorb information provided by the clinician It was also perceived that direct interaction with the pediatricpatient was decreased due to a lack of engagement with the child Many younger children were distracted bytheir home setting and did not stay focused on the conversation Adolescents did actively engage Despitethese limitations, within 2 weeks, the office successfully provided care for disorders including food allergy,allergic rhinitis, asthma, urticaria and atopic dermatitis Partial physical exams were conducted, includingassessments of patient appearance, quality of conversation, face/eyelid/skin, chest excursion & chest wallsymmetry, respiratory effort, mental status, and mood/affect Counseling, education and gross patientassessments were effectively accomplished with parents expressing satisfaction with remote care Limitations were noted in the setting of an acute asthma exacerbation These included restrictions in patient assessment,such as vital signs and auscultation of breath sounds Despite counseling and medication prescriptionprovided via telemedicine, the patient later sought emergency care via ED Discussion: rapid deployment wasachieved in a community small-office setting Successes included effective patient counseling and educationand delivery of patient care for non-emergent conditions These could be accomplished with the partialphysical exam available through audiovisual interface Limitations included decreased engagement of youngerchildren and the lack of document sharing, which can be addressed via other HIPAA-compliant technologyplatforms Asthma exacerbation was not effectively managed and illustrates the limitations of remotehealthcare in acute situations However, many patien","PeriodicalId":321596,"journal":{"name":"Section on Telehealth Care Program","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126484322","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}

引用次数: 0