Desai Chaitya, Pearce Ian, Modgil Vaibhav
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Manchester Andrology Centre, Manchester University NHS Foundation Trust, Manchester, UK.
Res Rep Urol. 2021 Sep 29;13:739-744. doi: 10.2147/RRU.S313881. eCollection 2021.
The impact of coronavirus disease 2019 presented an unprecedented challenge to urological service globally. In many countries, outpatient clinics were cancelled, and the use of telemedicine visits was increased. For urological complaints, the need to perform a sensitive clinical examination via telemedicine posed an unfamiliar environment. Our aim is to explore the clinical and ethical factors involved in performing remote sensitive clinical examinations.
A comprehensive review of literature and guidance from various medical bodies internationally was conducted using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar, and Research Gate in the first week of March 2021 including "COVID-19," "telemedicine," "urology," and "sensitive examinations."
Telemedicine reduced unnecessary visits to medical facilities and was useful for reducing the risk of transmission during the COVID-19 pandemic. We propose that in order to perform a sensitive clinical examination via telemedicine, the following four steps must be considered: assessment of the clinical need, obtaining informed consent, use of a chaperone, and thorough documentation.
Telemedicine will play a pivotal role in the future of urological practice beyond this present pandemic. However, sensitive clinical examinations using such technology must be performed in appropriate settings and situations. Suitable training, enhanced documentation, communication, and observing information governance guidance will aid in avoiding clinical and ethical pitfalls.
2019年冠状病毒病的影响给全球泌尿外科服务带来了前所未有的挑战。在许多国家，门诊被取消，远程医疗就诊的使用增加。对于泌尿外科疾病，通过远程医疗进行敏感的临床检查面临着一个陌生的环境。我们的目的是探讨进行远程敏感临床检查所涉及的临床和伦理因素。
2021年3月的第一周，在PubMed、SCOPUS、谷歌学术和Research Gate的搜索引擎上使用合适的关键词，对国际上各种医学机构的文献和指南进行了全面回顾，关键词包括“COVID-19”“远程医疗”“泌尿外科”和“敏感检查”。
远程医疗减少了对医疗机构的不必要就诊，有助于在COVID-19大流行期间降低传播风险。我们建议，为了通过远程医疗进行敏感的临床检查，必须考虑以下四个步骤：评估临床需求、获得知情同意、使用陪诊人员以及详细记录。
远程医疗在当前这场大流行之外的泌尿外科实践未来中将发挥关键作用。然而，使用此类技术进行敏感的临床检查必须在适当的环境和情况下进行。适当的培训、加强记录、沟通以及遵守信息管理指南将有助于避免临床和伦理陷阱。
