Department of Surgery, University of Manitoba, Winnipeg, MB, Canada.
Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
Can J Neurol Sci. 2023 Mar;50(2):257-261. doi: 10.1017/cjn.2022.18. Epub 2022 Mar 11.
To examine the use of telemedicine among Canadian concussion providers and clinics before and after the COVID-19 pandemic onset and identify barriers and facilitators for future use.
Ninety-nine concussion clinics and healthcare providers across Canada that offered one or more clinical concussion-related service were identified using standardized online searches and approached to complete a cross-sectional online survey.
Thirty clinics or providers completed the survey and two completed subsections of the survey (response rate of 32.3%). Only 28.1% of respondents indicated that they used telemedicine to provide care prior to the COVID-19 pandemic. Providers most commonly using telemedicine prior to the pandemic were occupational therapists and physicians, while the most commonly used services were in-person videoconferencing and eConsultation. Most respondents (87%) indicated their clinic's use of telemedicine changed following the onset of the COVID-19 pandemic including new use of in-person video-conferencing, telephone calls, and eConsultation. Ninety-three percent indicated that they would consider using telemedicine to provide care to their concussion patients once the pandemic was over. Barriers needed to be overcome to facilitate use or greater use of telemedicine-based services were the inability to conduct a complete physical examination, lack of appropriate reimbursement, lack of start-up, and maintenance funding and medico-legal risk.
Telemedicine was used by a minority of Canadian concussion clinics and providers prior to the COVID-19 pandemic but was rapidly adopted by many facilities. This study provides important insight into the factors that must be considered to optimize use of telemedicine in concussion care in the future.
在 COVID-19 大流行前后，检查加拿大脑震荡提供者和诊所使用远程医疗的情况，并确定未来使用的障碍和促进因素。
使用标准化的在线搜索，确定了加拿大的 99 个脑震荡诊所和医疗保健提供者，这些诊所和提供者提供了一种或多种临床脑震荡相关服务，并邀请他们完成横断面在线调查。
有 30 个诊所或提供者完成了调查，其中 2 个完成了调查的两个部分（回应率为 32.3%）。只有 28.1%的受访者表示，他们在 COVID-19 大流行前曾使用远程医疗提供护理。在大流行前最常使用远程医疗的是职业治疗师和医生，而最常使用的服务是现场视频会议和电子咨询。大多数受访者（87%）表示，他们的诊所自 COVID-19 大流行开始后，远程医疗的使用发生了变化，包括新使用现场视频会议、电话和电子咨询。93%的人表示，一旦大流行结束，他们将考虑使用远程医疗为脑震荡患者提供护理。为了促进或更多地使用基于远程医疗的服务，需要克服无法进行全面体检、缺乏适当的报销、缺乏启动和维持资金以及医疗法律风险等障碍。
在 COVID-19 大流行之前，只有少数加拿大脑震荡诊所和提供者使用远程医疗，但许多设施迅速采用了远程医疗。本研究为优化未来脑震荡护理中远程医疗的使用提供了重要的见解。
