Department of Neurological Surgery, Rush University, Chicago, Illinois, USA.
Department of Neurological Surgery, Rush University, Chicago, Illinois, USA.
World Neurosurg. 2021 Feb;146:e359-e367. doi: 10.1016/j.wneu.2020.10.101. Epub 2020 Oct 24.
Restricted access to hospitals due to the 2019 novel coronavirus disease (COVID-19) pandemic has significantly altered practice patterns for elective neurosurgical care. Particularly, telemedicine has become the primary modality of patient visits for nonemergent conditions. This study aimed to characterize user experiences of neurosurgeons and advanced practice providers focusing on perceived utility and barriers of telemedicine in management of elective neurosurgical patients during COVID-19.
An online survey was sent to clinicians involved in neurosurgical care using telemedicine with questions focusing on frequency of utilization, duration of patient encounters, benefits of telemedicine, and barriers to current forms of remote patient visits. Survey responses were stratified by clinical position (neurosurgeon vs. advanced practice provider) and subspecialty focus (cranial vs. spinal neurosurgery).
The survey was completed by 14 of 17 eligible clinicians. Respondents included 10 neurosurgeons and 4 APPs with 57% specializing in cranial neurosurgery and 43% specializing in spinal neurosurgery. During the COVID-19 period, 78% of respondents used teleconference/video conference visits multiple times in a week, and 86% planned to continue using telemedicine after the pandemic. The most common barrier for telemedicine was the inability to perform a neurological examination, while the most common perceived benefit was increased convenience for patients.
During the COVID-19 period, telemedicine was heavily relied on to ensure the continuation of perioperative care for patients with elective neurosurgical pathologies. While clinicians identified numerous barriers for current telemedicine platforms, the use of telemedicine will likely continue, as it has provided unique benefits for patients, clinicians, and hospitals.
由于 2019 年新型冠状病毒病(COVID-19)大流行,医院的就诊受到限制,这极大地改变了择期神经外科护理的实践模式。特别是,远程医疗已成为非紧急情况下患者就诊的主要方式。本研究旨在描述神经外科医生和高级执业医师的用户体验,重点关注在 COVID-19 期间管理择期神经外科患者时远程医疗的感知效用和障碍。
使用远程医疗向参与神经外科护理的临床医生发送在线调查,问题集中在利用率、患者就诊时长、远程医疗的益处以及当前远程患者就诊形式的障碍。调查结果按临床职位(神经外科医生与高级执业医师)和专科重点(颅脑神经外科与脊柱神经外科)进行分层。
17 名符合条件的临床医生中有 14 名完成了调查。受访者包括 10 名神经外科医生和 4 名 APP,其中 57%的人专门从事颅脑神经外科,43%的人专门从事脊柱神经外科。在 COVID-19 期间,78%的受访者每周多次使用电话会议/视频会议就诊,86%的人计划在大流行后继续使用远程医疗。远程医疗最常见的障碍是无法进行神经系统检查,而最常见的感知益处是增加了患者的便利性。
在 COVID-19 期间,远程医疗被广泛用于确保择期神经外科患者的围手术期护理的连续性。虽然临床医生发现了当前远程医疗平台的许多障碍,但远程医疗的使用可能会继续,因为它为患者、临床医生和医院提供了独特的益处。