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Racing against the Clock, Winning Back Time Spent in EHR
Published in Salvatore Volpe, Health Informatics, 2022
Find the time-saving documentation method that works best for each physician. Multiple studies show similar findings. In one study of family physicians in a teaching hospital, the average visit length was 35.8 minutes, including 2.9 minutes working in the EHR before the physician entering the room, two minutes working in the EHR while in the room, and 6.9 minutes on EHR work outside of typical clinic hours. The average visit included 7.5 minutes of non-face-to-face time, much of which was spent with the EHR. The average patient visit comprised 16.5 minutes of face-to-face time with the patient. First-year residents, or interns, spend nearly 90% of their work time away from patients, half of which is spent interacting with electronic health records and documentation. Most of that time, 10.3 hours, was spent on interacting with EHRs.8 Use voice recognition, dictation, scribes (the scribe can also order labs and x-rays as requested by the physician; a physician can focus on the patient and does not need to navigate the EHR or worry about inputting data at all), templates, remote scribes, or some combination of these. The critical point is that every physician works differently, and it is essential to find the way with which each physician is most comfortable and make it available. This will improve facetime with the patient and lessen screen time.
Human biomedical research, medical innovations and information technologies in healthcare †
Published in Gary Chan Kok Yew, Health Law and Medical Ethics in Singapore, 2020
The NTG are broad and generic, and individual specialities are encouraged to customise the NTG to meet the specific requirements of their respective fields. The NTG state that duty of care must be established in all telemedicine encounters and the responsibilities of patient/caregivers and roles of health professionals should be clarified. Healthcare professionals are enjoined to collaborate with each other to clearly define their roles and responsibilities. Further, the patient and caregiver should be given clear and explicit directions during the telemedicine encounters as to who has ongoing responsibility for any required follow-up and ongoing healthcare. With respect to standard of care in Telemedicine delivery, the overall standard must not be any less compared to a service not involving telemedicine. Where a face-to-face consultation is not reasonably practical, it is permitted to deliver care exclusively via Telemedicine as this is better than not having any access to care at all. On the other hand, where face-to-face consultations are reasonably practical, the delivery of Telemedicine must not compromise the overall quality of care provided as compared with non-Telemedicine care delivery.
Some particular challenges
Published in Roger Neighbour, Jamie Hynes, Helen Stokes-Lampard, Consulting in a Nutshell, 2020
Roger Neighbour, Jamie Hynes, Helen Stokes-Lampard
In essence, consultations by phone or video should follow the same structure as a face-to-face one, i.e. beginning with getting the patient's account of the problem as fully as possible, then obtaining all the information needed to assess it medically, and finally having the discussion from which an agreed plan of action can emerge. However, the limitations of phone and video as methods of communication mean that some compromises have to be made and some additional precautions taken. The obvious ones are that physical examination is impossible, and the exchange of visual information is non-existent by phone, and significantly restricted even on video. These constraints increase the risk of misdiagnosis and of misinterpreting what the patient is trying to communicate.
Impact of the covid-19 pandemic on amyotrophic lateral sclerosis care in the UK
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2023
Lucy S. Musson, Alexis Collins, Sarah Opie-Martin, Andrea Bredin, Esther V. Hobson, Emily Barkhouse, Mark C. Coulson, Theocharis Stavroulakis, Rebecca L. Gould, Ammar Al-Chalabi, Christopher J. McDermott
Most plwALS reported being satisfied with telephone appointments if there were no concerns. However, if a patient experienced a decline or had a particular worry, face-to-face consultations were preferred. Seventeen (46%) plwALS stated a preference for face-to-face consultations while fifteen (41%) preferred a hybrid model (involving in-person and remote appointments). HCPs explained the need to design and adopt new service delivery models using lessons learnt from the first wave of infections. Suggestions included having adequate supplies of personal protective equipment (PPE), adequate numbers of trained staff, continuing a multidisciplinary approach and allowing home visits to enable close monitoring of patients. The findings were used to generate a set of recommendations in relation to how we can best support plwALS in the context of a pandemic, as shown in Table 2.
Egyptian dermatologists attitude toward telemedicine amidst the COVID19 pandemic: a cross-sectional study
Published in Journal of Dermatological Treatment, 2022
Mohamed L. Elsaie, Hany A. Shehata, Noha S. Hanafi, Shady M. Ibrahim, Hany S. Ibrahim, Ayman Abdelmaksoud
In the current study, the majority of respondents 112 (40%) agreed that telemedicine is compatible with most of the dermatology work aspects and 235 (83.9%) agreed that amid this corona pandemic telemedicine represents a totally compatible solution. Concerning fitting with a dermatologist’s life style, 134 (47.9%) agreed that telemedicine would be a good fit. An advantage of dermatology is that it relies on visual diagnosis to a big extent which makes teledermatology and remote diagnosis compatible with the nature of the speciality. This does not eliminate the importance of face to face examination or procedural interventions that requires patients to be seen in person but can assist with triaging those who can be remotely consulted and those who require a face to face examination (32).
Is there still a role for digital rectal examination in the prostate cancer diagnostic pathway in the COVID-19 and post COVID-19 era?
Published in The Aging Male, 2021
Wei Shen Tan, Anton Wong, Wasim Mahmalji, Asif Raza
The current Coronavirus-19 (COVID-19) pandemic has resulted in the rapid adoption of technology by clinicians in efforts to maintain a semblance of a normal clinical service. Face-to-face outpatient appointments have largely been replaced with virtual consultations in the form of telephone or video consultations in order to minimise the risk to both the clinician and patient of COVID-19 transmission. Most patients with COVID-19 develop a fever and/or cough, although some patients remain relatively asymptomatic or present with isolated anosmia making identification of cases challenging. Further, the majority of patients referred with a suspicion of prostate cancer are >60 years old which is associated with a higher risk of COVID-19 related mortality [3]. The adoption of virtual clinics has meant that prostate cancer diagnostic pathways are now adapted to rely on PSA measurements and MRI scans, where radiological services are available, without the requirement for a DRE. Besides its role in prostate cancer diagnostics, MRI is also invaluable in the planning of treatment of prostate cancer [4].