Lapadula Maria C, Rolfs Shanna, Szyld Edgardo G, Hallford Gene, Clark Tracie, McCoy Mike, McKnight Stephanie, Makkar Abhishek
Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
University of Oklahoma College of Medicine, Oklahoma City, OK, United States.
Front Pediatr. 2021 Mar 3;9:642369. doi: 10.3389/fped.2021.642369. eCollection 2021.
During the COVID-19 pandemic, telemedicine plays a critical role in providing safe, effective healthcare services, while reinforcing social distancing and optimizing the use of personal protective equipment. In this context, the Oklahoma Children's Hospital implemented virtual neonatology prenatal visits for pregnant women with a diagnosis of fetal anomalies. While tele-consultations have been broadly used with a high degree of acceptance in rural and remote areas, satisfaction has not been assessed in this particular scenario, where patients and physicians discussing sensitive healthcare information had to rapidly adjust to this new modality. To evaluate patients' and neonatologists' satisfaction with virtual prenatal consultations in the context of the COVID-19 pandemic and to compare satisfaction levels of patients receiving virtual consultation with those receiving in-person consults. This cross-sectional study evaluated patients' and neonatologists' satisfaction with virtual consultations. Participants included pregnant women with diagnosis of fetal anomalies who received neonatology prenatal consultations at Oklahoma Children's Hospital, either in-person or through telemedicine, from May to mid-November 2020, and neonatologists providing virtual prenatal consultations in the same period. Virtual visits were delivered via Zoom Pro™. Patients and physicians who agreed to participate rated acceptability completing an anonymous 5-point Likert scale survey. Item frequencies and means for categories of items were computed by group (video-consult patients, in-person patients, physicians) and analyzed, using Welch's for unequal sample size. Overall consultation quality was rated good or excellent by 35 (100%) video-consult patients and 12 (100%) in-person patients. Patient group means computed on six 5-point Likert items about patient-physician communication did not differ significantly, video-consult: = 28.71 (2.22); in-person consult: = 28.92 (1.78) ( = 0.753263). All eight physicians (100%) agreed or strongly agreed that telemedicine was effective, using a 5-point Likert scale, and their combined consultation quality score computed on 10 survey questions was high: = 46.4 (3.11). Despite patient inexperience with tele-consultations, the quick implementation of telemedicine, and the sensitive reason for the visit, patients and physicians were highly satisfied with virtual visits. Telemedicine is a safe, effective alternative for providing neonatology prenatal consultations for pregnant women with diagnosis of fetal anomalies during the pandemic.
在新冠疫情期间，远程医疗在提供安全、有效的医疗服务方面发挥着关键作用，同时强化了社交距离并优化了个人防护装备的使用。在此背景下，俄克拉荷马儿童医院为诊断出胎儿异常的孕妇开展了虚拟新生儿科产前会诊。虽然远程会诊在农村和偏远地区已被广泛使用且接受度很高，但在这种特殊情况下，患者和医生讨论敏感医疗信息时必须迅速适应这种新模式，满意度尚未得到评估。为了评估在新冠疫情背景下患者和新生儿科医生对虚拟产前会诊的满意度，并比较接受虚拟会诊的患者与接受面对面会诊的患者的满意度水平。这项横断面研究评估了患者和新生儿科医生对虚拟会诊的满意度。参与者包括2020年5月至11月中旬在俄克拉荷马儿童医院接受新生儿科产前会诊的诊断出胎儿异常的孕妇，她们接受的是面对面会诊或通过远程医疗进行的会诊，以及同期提供虚拟产前会诊的新生儿科医生。虚拟会诊通过Zoom Pro™进行。同意参与的患者和医生通过完成一份匿名的5分李克特量表调查来对可接受性进行评分。按组（视频会诊患者、面对面会诊患者、医生）计算并分析项目类别的项目频率和均值，对于样本量不相等的情况使用韦尔奇检验。35名（100%）视频会诊患者和12名（100%）面对面会诊患者对总体会诊质量的评价为良好或优秀。在关于医患沟通的六个5分李克特项目上计算得出的患者组均值无显著差异，视频会诊：= 28.71（2.22）；面对面会诊：= 28.92（1.78）（= 0.753263）。所有八名医生（100%）使用5分李克特量表表示同意或强烈同意远程医疗是有效的，并且他们在10个调查问题上计算得出的综合会诊质量得分很高：= 46.4（3.11）。尽管患者缺乏远程会诊经验，远程医疗实施迅速，且会诊原因敏感，但患者和医生对虚拟会诊高度满意。在疫情期间，远程医疗是为诊断出胎儿异常孕妇提供新生儿科产前会诊的一种安全、有效的替代方式。
