University of Virginia, Charlottesville, VA.
University of Pittsburgh Medical Center, Department of Anesthesiology, Division of Pain Medicine, Pittsburgh, PA.
Pain Physician. 2022 Aug;25(5):387-390.
The COVID-19 pandemic resulted in a novel challenge for healthcare delivery and implementation in the United States (US) in 2020 and beyond. Telemedicine arose as a significant and effective medium for safe and efficacious physician-patient interactions. Prior to the COVID-19 pandemic, telemedicine while available, had infrequently been utilized in pain medicine practices due to difficulties with reimbursement, the learning curve associated with new technology usage, and the need for new logistical systems in place to implement telemedicine effectively. Given the unique constraints on the healthcare system during the COVID-19 pandemic, the ubiquitous utilization of telemedicine among pain medicine physicians increased, giving insight into potential future roles for the technology beyond the pandemic.
To survey and understand the state of implementation of telemedicine into pain medicine practices across practice settings and geographical areas; to identify potential barriers to the implementation of telemedicine in pain medicine practice; and to identify the likelihood of telemedicine continuing beyond the pandemic in pain medicine practice.
Online questionnaire targeting Pain Medicine physicians in the US. Participants were asked questions related to the use of telemedicine during the first peak of the COVID-19 pandemic.
Online-based questionnaire distributed to academic and private practice pain medicine physicians nationally in the United States.
A 34 web-based questionnaires were distributed by the American Society of Regional Anesthesia and Pain Medicine and the Spine Intervention Society to all active members. Data were analyzed using SAS v9.4.
Between December 3, 2020, and February 18, 2021, 164 participants accessed the survey with a response rate of 14.3%. Overall, academic physicians were more likely to implement telemedicine than private practice physicians. Telemedicine was also more frequently utilized for follow-up appointments rather than initial visits.
Although our n = 164, the overall low response rate of 14.3% warrants further investigation into the utilization of telemedicine throughout the COVID-19 pandemic.
Telemedicine as an emerging technology for efficient communication played a key role in mitigating the adverse effects of the COVID -19 pandemic on chronic pain patients. The utilization of telemedicine remarkably increased after the start of the pandemic within 1 to 2 weeks. Overall, private hospital-based centers were significantly less likely to implement telemedicine than academic centers, possibly due to limited access to secure telemedicine platforms and high start-up costs. Telemedicine was used more frequently for follow-up visits than initial visit encounters at most centers. In spite of the unforeseen consequences to the healthcare system and chronic pain practices in the US from COVID-19, telehealth has emerged as a unique model of care for patients with chronic pain. Although it has flaws, telehealth has the ability to increase access to care beyond the end of the pandemic. Further identification of barriers to the use of telemedicine platforms in private practices should be addressed from a policy perspective to facilitate increased care access.
2020 年及以后，新冠疫情给美国的医疗保健服务提供带来了新的挑战。远程医疗成为安全有效的医患互动的重要手段。在新冠疫情之前，尽管远程医疗已经存在，但由于报销困难、新技术使用的学习曲线以及有效实施远程医疗所需的新后勤系统，它在疼痛医学实践中很少被使用。鉴于新冠疫情期间医疗系统的独特限制，疼痛医学医生中广泛使用远程医疗的情况有所增加，这为该技术在疫情后的未来角色提供了一些启示。
调查和了解远程医疗在全美各种实践环境和地理区域的疼痛医学实践中的实施情况；确定疼痛医学实践中实施远程医疗的潜在障碍；并确定疼痛医学实践中远程医疗在疫情后的延续可能性。
针对美国疼痛医学医生的在线问卷调查。参与者被问及在新冠疫情第一波高峰期间使用远程医疗的相关问题。
在美国全国范围内，通过美国区域麻醉与疼痛医学学会和脊柱介入学会向学术和私人执业的疼痛医学医生在线分发问卷。
2020 年 12 月 3 日至 2021 年 2 月 18 日，共有 34 份在线问卷分发给美国所有活跃成员。使用 SAS v9.4 分析数据。
共有 164 名参与者访问了该调查，回复率为 14.3%。总体而言，学术医生比私人执业医生更有可能实施远程医疗。远程医疗也更多地用于随访预约，而不是初始就诊。
尽管我们的 n = 164，但总体上 14.3%的低回复率需要进一步调查整个新冠疫情期间远程医疗的使用情况。
远程医疗作为一种高效沟通的新兴技术，在减轻新冠疫情对慢性疼痛患者的不利影响方面发挥了关键作用。在疫情开始后的 1 到 2 周内，远程医疗的使用显著增加。总体而言，与学术中心相比，私立医院为基础的中心实施远程医疗的可能性显著较低，这可能是由于访问安全的远程医疗平台受限和启动成本高。在大多数中心，远程医疗更多地用于随访预约，而不是初始就诊。尽管新冠疫情给美国的医疗保健系统和慢性疼痛实践带来了意想不到的后果，但远程医疗已经成为慢性疼痛患者独特的护理模式。尽管存在缺陷，但远程医疗有能力在疫情结束后增加获得护理的机会。应从政策角度进一步确定在私人诊所使用远程医疗平台的障碍，以促进获得更多的医疗服务。
