Yoon Jang W, Welch Rachel L, Alamin Todd, Lavelle William F, Cheng Ivan, Perez-Cruet Mick, Fielding Louis C, Sasso Rick C, Linovitz R J, Kim Kee D, Welch William C
Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Yale College, Yale University, New Haven, Connecticut.
Int J Spine Surg. 2020 Jun 30;14(3):433-440. doi: 10.14444/7057. eCollection 2020 Jun.
With the COVID-19 pandemic disrupting many facets of our society, physicians and patients have begun using telemedicine as a platform for the delivery of health care. One of the challenges in implementing telemedicine for the spine care provider is completing a comprehensive spinal examination. Currently, there is no standardized methodology to complete a full spinal examination through telemedicine.
We propose a novel, remote spinal examination methodology that is easily implemented through telemedicine, where the patient is an active participant in the successful completion of his or her examination. This type of examination has been validated in a neurology setting. To facilitate the telemedicine visit, we propose that video instruction be shared with the patient prior to the telemedicine visit to increase the efficacy of the examination.
Since the issuance of stay-at-home order across the states, many spine practices around the country have rapidly adopted and increased their telemedicine program to continue provide care for patients during COVID-19 pandemic. At a tertiary academic center in a busy metropolitan area, nearly 700 telemedicine visits were successfully conducted during a 4-week period. There were no remote visits being done prior to the shutdown.
Implementation of our proposed remote spinal examination has the potential to serve as a guideline for the spine care provider to efficiently assess patients with spine disease using telemedicine. Because these are only suggestions, providers should tailor examination to each individual patient's needs.
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It is likely that physicians will incorporate telemedicine into health care delivery services even after the COVID-19 pandemic subsides because of telemedicine's efficiency in meeting patient needs. Using the standard maneuvers provided in our study, spine care providers can perform a nearly comprehensive spine examination through telemedicine. Further studies will be needed to validate the reproducibility and reliability of our methodology.
随着新冠疫情扰乱了社会的许多方面，医生和患者已开始将远程医疗作为提供医疗保健的平台。脊柱护理提供者实施远程医疗面临的挑战之一是完成全面的脊柱检查。目前，尚无通过远程医疗完成全面脊柱检查的标准化方法。
我们提出了一种新颖的远程脊柱检查方法，可通过远程医疗轻松实施，患者在成功完成其检查过程中是积极参与者。这种检查类型已在神经科环境中得到验证。为便于远程医疗就诊，我们建议在远程医疗就诊前与患者共享视频指导，以提高检查的效率。
自各州发布居家令以来，全国各地的许多脊柱诊疗机构迅速采用并扩大了他们的远程医疗项目，以便在新冠疫情期间继续为患者提供护理。在一个繁忙大都市地区的三级学术中心，在为期4周的时间里成功进行了近700次远程医疗就诊。在关闭之前没有进行过远程就诊。
实施我们提出的远程脊柱检查有可能为脊柱护理提供者提供指导，以便他们利用远程医疗有效地评估脊柱疾病患者。由于这些只是建议，提供者应根据每个患者的需求调整检查。
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即使在新冠疫情消退后，医生也可能会将远程医疗纳入医疗服务提供中，因为远程医疗在满足患者需求方面具有效率。使用我们研究中提供的标准操作，脊柱护理提供者可以通过远程医疗进行近乎全面的脊柱检查。需要进一步的研究来验证我们方法的可重复性和可靠性。
