Inova Sports Medicine Concussion Program, Fairfax, Virginia (Dr Womble); Baylor Scott & White Sports Concussion Program, Frisco, Texas (Dr Reynolds); Sports Medicine Concussion Program, Department of Orthopaedics, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Drs Kissinger-Knox, Collins, Kontos, and Eagle); Inova Sports Medicine, Fairfax, Virginia (Dr West); and Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville (Dr Elbin).
J Head Trauma Rehabil. 2022;37(2):E49-E54. doi: 10.1097/HTR.0000000000000713.
The coronavirus disease 2019 (COVID-19) pandemic has substantially altered the delivery of healthcare for providers and their patients. Patients have been reticent to seek care for many diseases and injuries including concussion due to fears of potential exposure to COVID-19. Moreover, because of social distancing recommendations and stay-at-home orders, patient screening, evaluation, and delivery of care have become less efficient or impossible to perform via in-person clinic visits. Consequently, there was a sudden need to shift healthcare delivery from primarily in-person visits to telehealth. This sudden shift in healthcare delivery brings with it both challenges and opportunities for clinical concussion care. This article is designed to discuss these challenges and opportunities and provide an experiential-based framework for providing concussion care via telehealth. We first provide an overview of a clinical concussion model utilized at concussion specialty clinics from 3 geographically disparate healthcare systems for in-person service delivery prior to COVID-19. We then discuss the creation of new clinical workflows to facilitate the continued provision of concussion specialty care using telehealth. Finally, we examine lessons learned during this healthcare delivery shift including limitations and potential barriers for telehealth for concussion care, as well as opportunities for expansion of concussion care in rural and underserved areas. We also discuss the need to empirically evaluate the comparative efficacy of telehealth and in-person concussion care moving forward.
2019 年冠状病毒病（COVID-19）大流行极大地改变了医疗保健提供者及其患者的医疗服务方式。由于担心可能接触到 COVID-19，许多患者对于包括脑震荡在内的许多疾病和伤害都不愿寻求治疗。此外，由于社会隔离建议和居家令，患者的筛查、评估和护理效率降低，或者无法通过门诊进行。因此，突然需要将医疗保健服务从主要的门诊就诊转变为远程医疗。这种医疗保健服务的突然转变为临床脑震荡护理带来了挑战和机遇。本文旨在讨论这些挑战和机遇，并提供一个基于经验的框架，通过远程医疗提供脑震荡护理。我们首先概述了 COVID-19 之前在三个地理位置不同的医疗保健系统中用于门诊服务的临床脑震荡模型。然后，我们讨论了创建新的临床工作流程，以通过远程医疗促进持续提供脑震荡专科护理。最后，我们研究了在这一医疗服务转变过程中吸取的经验教训，包括远程医疗治疗脑震荡的局限性和潜在障碍，以及在农村和服务不足地区扩大脑震荡护理的机会。我们还讨论了需要对远程医疗和门诊脑震荡护理的相对疗效进行实证评估。
