Division of Pediatric Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA.
Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):9765-9769. doi: 10.1080/14767058.2022.2053101. Epub 2022 Mar 25.
Comprehensive fetal care centers address congenital anomalies by developing pre- and post-natal care plans in a multidisciplinary format. To reduce exposure during the Coronavirus Infectious Disease-2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) broadened access to telehealth services. We assessed provider satisfaction with the rapid transition from in-person prenatal visits to multidisciplinary consultations telehealth as an adaptive response to the pandemic.
Patients referred to an urban academic fetal care center during the first 6 weeks of the COVID-19 pandemic underwent advanced imaging including fetal MRI, focused ultrasound, and fetal echocardiography. Subsequently, multidisciplinary telehealth consultations occurred with all providers attending virtually. Patients were given the option of attending the multidisciplinary telehealth consultation in a conference room in the hospital or from home. During these meetings, relevant images were reviewed with all participants screen sharing through a secure video platform. Provider satisfaction with the telehealth paradigm was assessed using an electronic survey.
Twenty-two surveys were administered with a response rate of 82%. 89% of providers were highly satisfied with the telehealth format. 72% of providers would prefer the multidisciplinary telehealth format to an in-person visit for future visits after COVID-19 restrictions are lifted. 22% of providers would leave the choice to the patient's family. One provider preferred in-person visits. Some providers noted that virtual conferences limited the ability to draw pictures, show educational materials, and provide emotional support.
Providers were overwhelmingly supportive of continuing multidisciplinary telehealth conferences for complex prenatal consultations, even after restrictions are lifted, which has led to the continuation of this model for the duration of the pandemic. Providers highlighted the convenience and improved care coordination across specialties. Further studies to examine the patient experience with virtual consultations are warranted.
综合胎儿保健中心通过以多学科形式制定产前和产后护理计划来处理先天异常。为了减少在 2019 年冠状病毒病(COVID-19)大流行期间的暴露,医疗保险和医疗补助服务中心(CMS)扩大了远程医疗服务的获取渠道。我们评估了提供者对从面对面产前就诊快速过渡到多学科咨询的满意度 - 远程医疗是对大流行的适应性反应。
在 COVID-19 大流行的前 6 周,将患者转诊到城市学术胎儿保健中心,进行先进的成像检查,包括胎儿 MRI、聚焦超声和胎儿超声心动图。随后,所有提供者都通过虚拟方式进行多学科远程医疗咨询。患者可以选择在医院会议室或家中参加多学科远程医疗咨询。在这些会议上,所有参与者都可以通过安全视频平台共享相关图像。通过电子调查评估提供者对远程医疗模式的满意度。
共进行了 22 次调查,回复率为 82%。89%的提供者对远程医疗模式非常满意。72%的提供者希望在 COVID-19 限制解除后,未来就诊时采用多学科远程医疗模式而不是面对面就诊。22%的提供者将选择权留给患者的家属。有 1 名提供者更喜欢面对面就诊。一些提供者指出,虚拟会议限制了画图画、展示教育材料和提供情感支持的能力。
提供者非常支持继续进行复杂的产前咨询多学科远程医疗会议,即使在限制解除后也是如此,这导致该模式在大流行期间得以持续。提供者强调了便利性和跨专业的更好的护理协调。有必要进一步研究虚拟咨询的患者体验。