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LitCovid-PD-FMA-UBERON

{"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T15","span":{"begin":288,"end":292},"obj":"Body_part"},{"id":"T16","span":{"begin":301,"end":305},"obj":"Body_part"},{"id":"T17","span":{"begin":2606,"end":2610},"obj":"Body_part"},{"id":"T18","span":{"begin":2614,"end":2618},"obj":"Body_part"},{"id":"T19","span":{"begin":3931,"end":3935},"obj":"Body_part"},{"id":"T20","span":{"begin":6930,"end":6934},"obj":"Body_part"}],"attributes":[{"id":"A15","pred":"fma_id","subj":"T15","obj":"http://purl.org/sig/ont/fma/fma7154"},{"id":"A16","pred":"fma_id","subj":"T16","obj":"http://purl.org/sig/ont/fma/fma7154"},{"id":"A17","pred":"fma_id","subj":"T17","obj":"http://purl.org/sig/ont/fma/fma25056"},{"id":"A18","pred":"fma_id","subj":"T18","obj":"http://purl.org/sig/ont/fma/fma25056"},{"id":"A19","pred":"fma_id","subj":"T19","obj":"http://purl.org/sig/ont/fma/fma25056"},{"id":"A20","pred":"fma_id","subj":"T20","obj":"http://purl.org/sig/ont/fma/fma25056"}],"text":"5.2 Challenges in telepsychology deployment\n\n5.2.1 Limited clinic capacity\nAs we made our rapid transition to telepsychology, we needed to adjust to the unique parameters of each site. Therefore, supervisors collaborated with key personnel at individual sites (e.g., medical directors, head nurses, head administrators) to identify site‐specific changes to our procedures. For example, some sites provided the administrative support to reach already scheduled patients to inform them of our move to telepsychology, whereas others preferred for our team to take the lead in contacting patients. Similarly, while all of our clinics had electronic medical records that could be accessed remotely, some sites did not have the capacity for us remotely to enter appointments into their scheduling system, and thus we had to create our own password‐protected and encrypted schedules. Those schedules were then shared with the medical staff so they could add a patient as needed and know which patients had attended telepsychology appointments.\nThe fundamental premise of primary care psychology is to provide brief services to as wide a cross‐section of patients as possible, aiming to improve the behavioral health of the entire clinic population. To achieve the promise of this population‐based approach to primary care, a steady flow of referrals from physicians and/or routine screenings are needed. However, nationally and within our primary care clinics as well, there was a dramatic cutback in primary care visits, especially visits aimed at chronic conditions, routine check‐ups, or prevention. Furthermore, our free clinic partners that rely on part‐time volunteers to provide a percentage of their care had to furlough many of those volunteers for safety reasons. Seeing fewer patients leads to fewer referrals. Additionally, with our primary care colleagues in medicine embarking on their own steep learning curve to shifting to telehealth, some of our clinicians lost bandwidth they usually have to discuss behavioral health issues with their patients. Lastly, without our physical presence in their workspace, our medical colleagues did not have the usual visual reminders or verbal prompts from our clinicians asking for referrals. This sudden drop‐off in referrals was experienced across the spectrum of integrated care providers nationally, who were weighing in daily on listservs about their challenges with similar transitions in integrated care.\n\n5.2.2 Scheduling\nAnother advantage of the integrated care model is being able to schedule medical and behavioral health/psychology appointments back to back. This decreases barriers such as transportation and efficiency in taking time off from work or finding child care. But with telepsychology, this actually poses a greater challenge in some cases. With some medical appointments still taking place in person, patients were not in a private space right before or after their appointment but entering or leaving the clinic, making it difficult to “attend” their telepsychology appointment.\nWhile no‐shows are generally less common with telepsychology, patients can sometimes take the clinician's time for granted and can attach less importance to sessions where they do not have to make the investment of showing up in person. Patients were not always “available” at the time of their appointment. In one case, a woman's partner answered the phone and shared her message that she was getting her nails done and was not available. Other times, patients had been sleeping, had just woken up and engaged in the session in bed, were eating during a session, or spent the initial few minutes of the session trying to find a quiet location within their residence. The latter was especially challenging for patients with children or roommates. Given the greater possibility for unexpected disruptions to plans, it was not uncommon for patients to ask our clinicians to call back at a later time.\n\n5.2.3 Technology\nAnother challenge in rolling out telepsychology services was getting patients to feel comfortable using videoconferencing services. Initially, most of our telepsychology visits were conducted via telephone, due to patient preference and concerns about using an unfamiliar technology. As one integrated care professional concluded after surveying his colleagues about how many clinicians were finding this same challenge, despite all of our efforts to set up videoconferencing the telephone is still king. As a result of this trend, our therapists were having to learn to navigate telepsychology sessions relying solely upon verbal cues (e.g., tone of voice).\nEven with this initial bias toward choosing telephone services, we continued to push toward providing more and more services via Zoom videoconferencing, for the obvious advantages it affords in communication and rapport building. Another barrier was also the comfort level of the trainees, as the phone in some ways was an easier adjustment, and the thought of walking a patient through navigating Zoom felt like an additional hurdle. As our trainees became more confident in telepsychology delivery, they also became more comfortable in selling this upgraded service. Also, as patients begin using video service with other health care providers and even for social visits with family and friends during this extended period of social distancing, we are anticipating they will feel more comfort with this technology.\n\n5.2.4 Accessibility and diversity issues\nOur primary care psychology team contended with a number of accessibility and diversity challenges in the provision of telepsychology services to the marginalized communities with whom we work. We had difficulty reaching some patients, and many did not recognize the masked or “blocked” phone number calling them. Others did not have voicemail systems set up or had full voicemail boxes. Accessibility concerns, such as restricted data for video telepsychology calls and limited use left on prepaid phones also constrained patients' ability to engage in telepsychology. Furthermore, a subset of patients were undocumented immigrants or had undocumented family members, and we recognize that they may not have wanted to show on video their location during a telepsychology call. Similarly, patients and their families may not have wanted to show their homes on video either. By contrast, many patients were very open to telepsychology delivered via telephone if they had concerns about video.\nAs another inclusion‐related challenge, we realized that we needed to translate our telepsychology informed consent script into Spanish. Some of the clinics with whom we work did not have reliable translation services during this time, and therefore, our Spanish‐speaking doctoral trainees were providing care for those patients and their families who needed sessions in Spanish. Thus, we had our team of Spanish‐speaking clinicians translate and back‐translate our consent script, with their bilingual supervisor checking their work. Finally, as is true across the nation, many low‐income families include adults who were essential workers (e.g., in construction, food service, nursing). Thus, we found that our patients’ families were having to balance trying keep each other safe from any possible contamination when that person returned home, which, in turn, was contributing to the stress level of our patients and their families."}

LitCovid-PD-UBERON

{"project":"LitCovid-PD-UBERON","denotations":[{"id":"T4","span":{"begin":288,"end":292},"obj":"Body_part"},{"id":"T5","span":{"begin":301,"end":305},"obj":"Body_part"}],"attributes":[{"id":"A4","pred":"uberon_id","subj":"T4","obj":"http://purl.obolibrary.org/obo/UBERON_0000033"},{"id":"A5","pred":"uberon_id","subj":"T5","obj":"http://purl.obolibrary.org/obo/UBERON_0000033"}],"text":"5.2 Challenges in telepsychology deployment\n\n5.2.1 Limited clinic capacity\nAs we made our rapid transition to telepsychology, we needed to adjust to the unique parameters of each site. Therefore, supervisors collaborated with key personnel at individual sites (e.g., medical directors, head nurses, head administrators) to identify site‐specific changes to our procedures. For example, some sites provided the administrative support to reach already scheduled patients to inform them of our move to telepsychology, whereas others preferred for our team to take the lead in contacting patients. Similarly, while all of our clinics had electronic medical records that could be accessed remotely, some sites did not have the capacity for us remotely to enter appointments into their scheduling system, and thus we had to create our own password‐protected and encrypted schedules. Those schedules were then shared with the medical staff so they could add a patient as needed and know which patients had attended telepsychology appointments.\nThe fundamental premise of primary care psychology is to provide brief services to as wide a cross‐section of patients as possible, aiming to improve the behavioral health of the entire clinic population. To achieve the promise of this population‐based approach to primary care, a steady flow of referrals from physicians and/or routine screenings are needed. However, nationally and within our primary care clinics as well, there was a dramatic cutback in primary care visits, especially visits aimed at chronic conditions, routine check‐ups, or prevention. Furthermore, our free clinic partners that rely on part‐time volunteers to provide a percentage of their care had to furlough many of those volunteers for safety reasons. Seeing fewer patients leads to fewer referrals. Additionally, with our primary care colleagues in medicine embarking on their own steep learning curve to shifting to telehealth, some of our clinicians lost bandwidth they usually have to discuss behavioral health issues with their patients. Lastly, without our physical presence in their workspace, our medical colleagues did not have the usual visual reminders or verbal prompts from our clinicians asking for referrals. This sudden drop‐off in referrals was experienced across the spectrum of integrated care providers nationally, who were weighing in daily on listservs about their challenges with similar transitions in integrated care.\n\n5.2.2 Scheduling\nAnother advantage of the integrated care model is being able to schedule medical and behavioral health/psychology appointments back to back. This decreases barriers such as transportation and efficiency in taking time off from work or finding child care. But with telepsychology, this actually poses a greater challenge in some cases. With some medical appointments still taking place in person, patients were not in a private space right before or after their appointment but entering or leaving the clinic, making it difficult to “attend” their telepsychology appointment.\nWhile no‐shows are generally less common with telepsychology, patients can sometimes take the clinician's time for granted and can attach less importance to sessions where they do not have to make the investment of showing up in person. Patients were not always “available” at the time of their appointment. In one case, a woman's partner answered the phone and shared her message that she was getting her nails done and was not available. Other times, patients had been sleeping, had just woken up and engaged in the session in bed, were eating during a session, or spent the initial few minutes of the session trying to find a quiet location within their residence. The latter was especially challenging for patients with children or roommates. Given the greater possibility for unexpected disruptions to plans, it was not uncommon for patients to ask our clinicians to call back at a later time.\n\n5.2.3 Technology\nAnother challenge in rolling out telepsychology services was getting patients to feel comfortable using videoconferencing services. Initially, most of our telepsychology visits were conducted via telephone, due to patient preference and concerns about using an unfamiliar technology. As one integrated care professional concluded after surveying his colleagues about how many clinicians were finding this same challenge, despite all of our efforts to set up videoconferencing the telephone is still king. As a result of this trend, our therapists were having to learn to navigate telepsychology sessions relying solely upon verbal cues (e.g., tone of voice).\nEven with this initial bias toward choosing telephone services, we continued to push toward providing more and more services via Zoom videoconferencing, for the obvious advantages it affords in communication and rapport building. Another barrier was also the comfort level of the trainees, as the phone in some ways was an easier adjustment, and the thought of walking a patient through navigating Zoom felt like an additional hurdle. As our trainees became more confident in telepsychology delivery, they also became more comfortable in selling this upgraded service. Also, as patients begin using video service with other health care providers and even for social visits with family and friends during this extended period of social distancing, we are anticipating they will feel more comfort with this technology.\n\n5.2.4 Accessibility and diversity issues\nOur primary care psychology team contended with a number of accessibility and diversity challenges in the provision of telepsychology services to the marginalized communities with whom we work. We had difficulty reaching some patients, and many did not recognize the masked or “blocked” phone number calling them. Others did not have voicemail systems set up or had full voicemail boxes. Accessibility concerns, such as restricted data for video telepsychology calls and limited use left on prepaid phones also constrained patients' ability to engage in telepsychology. Furthermore, a subset of patients were undocumented immigrants or had undocumented family members, and we recognize that they may not have wanted to show on video their location during a telepsychology call. Similarly, patients and their families may not have wanted to show their homes on video either. By contrast, many patients were very open to telepsychology delivered via telephone if they had concerns about video.\nAs another inclusion‐related challenge, we realized that we needed to translate our telepsychology informed consent script into Spanish. Some of the clinics with whom we work did not have reliable translation services during this time, and therefore, our Spanish‐speaking doctoral trainees were providing care for those patients and their families who needed sessions in Spanish. Thus, we had our team of Spanish‐speaking clinicians translate and back‐translate our consent script, with their bilingual supervisor checking their work. Finally, as is true across the nation, many low‐income families include adults who were essential workers (e.g., in construction, food service, nursing). Thus, we found that our patients’ families were having to balance trying keep each other safe from any possible contamination when that person returned home, which, in turn, was contributing to the stress level of our patients and their families."}

LitCovid-PD-CLO

LitCovid-PD-CHEBI

{"project":"LitCovid-PD-CHEBI","denotations":[{"id":"T13","span":{"begin":1867,"end":1875},"obj":"Chemical"}],"attributes":[{"id":"A13","pred":"chebi_id","subj":"T13","obj":"http://purl.obolibrary.org/obo/CHEBI_23888"}],"text":"5.2 Challenges in telepsychology deployment\n\n5.2.1 Limited clinic capacity\nAs we made our rapid transition to telepsychology, we needed to adjust to the unique parameters of each site. Therefore, supervisors collaborated with key personnel at individual sites (e.g., medical directors, head nurses, head administrators) to identify site‐specific changes to our procedures. For example, some sites provided the administrative support to reach already scheduled patients to inform them of our move to telepsychology, whereas others preferred for our team to take the lead in contacting patients. Similarly, while all of our clinics had electronic medical records that could be accessed remotely, some sites did not have the capacity for us remotely to enter appointments into their scheduling system, and thus we had to create our own password‐protected and encrypted schedules. Those schedules were then shared with the medical staff so they could add a patient as needed and know which patients had attended telepsychology appointments.\nThe fundamental premise of primary care psychology is to provide brief services to as wide a cross‐section of patients as possible, aiming to improve the behavioral health of the entire clinic population. To achieve the promise of this population‐based approach to primary care, a steady flow of referrals from physicians and/or routine screenings are needed. However, nationally and within our primary care clinics as well, there was a dramatic cutback in primary care visits, especially visits aimed at chronic conditions, routine check‐ups, or prevention. Furthermore, our free clinic partners that rely on part‐time volunteers to provide a percentage of their care had to furlough many of those volunteers for safety reasons. Seeing fewer patients leads to fewer referrals. Additionally, with our primary care colleagues in medicine embarking on their own steep learning curve to shifting to telehealth, some of our clinicians lost bandwidth they usually have to discuss behavioral health issues with their patients. Lastly, without our physical presence in their workspace, our medical colleagues did not have the usual visual reminders or verbal prompts from our clinicians asking for referrals. This sudden drop‐off in referrals was experienced across the spectrum of integrated care providers nationally, who were weighing in daily on listservs about their challenges with similar transitions in integrated care.\n\n5.2.2 Scheduling\nAnother advantage of the integrated care model is being able to schedule medical and behavioral health/psychology appointments back to back. This decreases barriers such as transportation and efficiency in taking time off from work or finding child care. But with telepsychology, this actually poses a greater challenge in some cases. With some medical appointments still taking place in person, patients were not in a private space right before or after their appointment but entering or leaving the clinic, making it difficult to “attend” their telepsychology appointment.\nWhile no‐shows are generally less common with telepsychology, patients can sometimes take the clinician's time for granted and can attach less importance to sessions where they do not have to make the investment of showing up in person. Patients were not always “available” at the time of their appointment. In one case, a woman's partner answered the phone and shared her message that she was getting her nails done and was not available. Other times, patients had been sleeping, had just woken up and engaged in the session in bed, were eating during a session, or spent the initial few minutes of the session trying to find a quiet location within their residence. The latter was especially challenging for patients with children or roommates. Given the greater possibility for unexpected disruptions to plans, it was not uncommon for patients to ask our clinicians to call back at a later time.\n\n5.2.3 Technology\nAnother challenge in rolling out telepsychology services was getting patients to feel comfortable using videoconferencing services. Initially, most of our telepsychology visits were conducted via telephone, due to patient preference and concerns about using an unfamiliar technology. As one integrated care professional concluded after surveying his colleagues about how many clinicians were finding this same challenge, despite all of our efforts to set up videoconferencing the telephone is still king. As a result of this trend, our therapists were having to learn to navigate telepsychology sessions relying solely upon verbal cues (e.g., tone of voice).\nEven with this initial bias toward choosing telephone services, we continued to push toward providing more and more services via Zoom videoconferencing, for the obvious advantages it affords in communication and rapport building. Another barrier was also the comfort level of the trainees, as the phone in some ways was an easier adjustment, and the thought of walking a patient through navigating Zoom felt like an additional hurdle. As our trainees became more confident in telepsychology delivery, they also became more comfortable in selling this upgraded service. Also, as patients begin using video service with other health care providers and even for social visits with family and friends during this extended period of social distancing, we are anticipating they will feel more comfort with this technology.\n\n5.2.4 Accessibility and diversity issues\nOur primary care psychology team contended with a number of accessibility and diversity challenges in the provision of telepsychology services to the marginalized communities with whom we work. We had difficulty reaching some patients, and many did not recognize the masked or “blocked” phone number calling them. Others did not have voicemail systems set up or had full voicemail boxes. Accessibility concerns, such as restricted data for video telepsychology calls and limited use left on prepaid phones also constrained patients' ability to engage in telepsychology. Furthermore, a subset of patients were undocumented immigrants or had undocumented family members, and we recognize that they may not have wanted to show on video their location during a telepsychology call. Similarly, patients and their families may not have wanted to show their homes on video either. By contrast, many patients were very open to telepsychology delivered via telephone if they had concerns about video.\nAs another inclusion‐related challenge, we realized that we needed to translate our telepsychology informed consent script into Spanish. Some of the clinics with whom we work did not have reliable translation services during this time, and therefore, our Spanish‐speaking doctoral trainees were providing care for those patients and their families who needed sessions in Spanish. Thus, we had our team of Spanish‐speaking clinicians translate and back‐translate our consent script, with their bilingual supervisor checking their work. Finally, as is true across the nation, many low‐income families include adults who were essential workers (e.g., in construction, food service, nursing). Thus, we found that our patients’ families were having to balance trying keep each other safe from any possible contamination when that person returned home, which, in turn, was contributing to the stress level of our patients and their families."}

LitCovid-PD-GO-BP

{"project":"LitCovid-PD-GO-BP","denotations":[{"id":"T6","span":{"begin":1905,"end":1913},"obj":"http://purl.obolibrary.org/obo/GO_0007612"},{"id":"T7","span":{"begin":3593,"end":3599},"obj":"http://purl.obolibrary.org/obo/GO_0007631"},{"id":"T8","span":{"begin":6680,"end":6691},"obj":"http://purl.obolibrary.org/obo/GO_0006412"}],"text":"5.2 Challenges in telepsychology deployment\n\n5.2.1 Limited clinic capacity\nAs we made our rapid transition to telepsychology, we needed to adjust to the unique parameters of each site. Therefore, supervisors collaborated with key personnel at individual sites (e.g., medical directors, head nurses, head administrators) to identify site‐specific changes to our procedures. For example, some sites provided the administrative support to reach already scheduled patients to inform them of our move to telepsychology, whereas others preferred for our team to take the lead in contacting patients. Similarly, while all of our clinics had electronic medical records that could be accessed remotely, some sites did not have the capacity for us remotely to enter appointments into their scheduling system, and thus we had to create our own password‐protected and encrypted schedules. Those schedules were then shared with the medical staff so they could add a patient as needed and know which patients had attended telepsychology appointments.\nThe fundamental premise of primary care psychology is to provide brief services to as wide a cross‐section of patients as possible, aiming to improve the behavioral health of the entire clinic population. To achieve the promise of this population‐based approach to primary care, a steady flow of referrals from physicians and/or routine screenings are needed. However, nationally and within our primary care clinics as well, there was a dramatic cutback in primary care visits, especially visits aimed at chronic conditions, routine check‐ups, or prevention. Furthermore, our free clinic partners that rely on part‐time volunteers to provide a percentage of their care had to furlough many of those volunteers for safety reasons. Seeing fewer patients leads to fewer referrals. Additionally, with our primary care colleagues in medicine embarking on their own steep learning curve to shifting to telehealth, some of our clinicians lost bandwidth they usually have to discuss behavioral health issues with their patients. Lastly, without our physical presence in their workspace, our medical colleagues did not have the usual visual reminders or verbal prompts from our clinicians asking for referrals. This sudden drop‐off in referrals was experienced across the spectrum of integrated care providers nationally, who were weighing in daily on listservs about their challenges with similar transitions in integrated care.\n\n5.2.2 Scheduling\nAnother advantage of the integrated care model is being able to schedule medical and behavioral health/psychology appointments back to back. This decreases barriers such as transportation and efficiency in taking time off from work or finding child care. But with telepsychology, this actually poses a greater challenge in some cases. With some medical appointments still taking place in person, patients were not in a private space right before or after their appointment but entering or leaving the clinic, making it difficult to “attend” their telepsychology appointment.\nWhile no‐shows are generally less common with telepsychology, patients can sometimes take the clinician's time for granted and can attach less importance to sessions where they do not have to make the investment of showing up in person. Patients were not always “available” at the time of their appointment. In one case, a woman's partner answered the phone and shared her message that she was getting her nails done and was not available. Other times, patients had been sleeping, had just woken up and engaged in the session in bed, were eating during a session, or spent the initial few minutes of the session trying to find a quiet location within their residence. The latter was especially challenging for patients with children or roommates. Given the greater possibility for unexpected disruptions to plans, it was not uncommon for patients to ask our clinicians to call back at a later time.\n\n5.2.3 Technology\nAnother challenge in rolling out telepsychology services was getting patients to feel comfortable using videoconferencing services. Initially, most of our telepsychology visits were conducted via telephone, due to patient preference and concerns about using an unfamiliar technology. As one integrated care professional concluded after surveying his colleagues about how many clinicians were finding this same challenge, despite all of our efforts to set up videoconferencing the telephone is still king. As a result of this trend, our therapists were having to learn to navigate telepsychology sessions relying solely upon verbal cues (e.g., tone of voice).\nEven with this initial bias toward choosing telephone services, we continued to push toward providing more and more services via Zoom videoconferencing, for the obvious advantages it affords in communication and rapport building. Another barrier was also the comfort level of the trainees, as the phone in some ways was an easier adjustment, and the thought of walking a patient through navigating Zoom felt like an additional hurdle. As our trainees became more confident in telepsychology delivery, they also became more comfortable in selling this upgraded service. Also, as patients begin using video service with other health care providers and even for social visits with family and friends during this extended period of social distancing, we are anticipating they will feel more comfort with this technology.\n\n5.2.4 Accessibility and diversity issues\nOur primary care psychology team contended with a number of accessibility and diversity challenges in the provision of telepsychology services to the marginalized communities with whom we work. We had difficulty reaching some patients, and many did not recognize the masked or “blocked” phone number calling them. Others did not have voicemail systems set up or had full voicemail boxes. Accessibility concerns, such as restricted data for video telepsychology calls and limited use left on prepaid phones also constrained patients' ability to engage in telepsychology. Furthermore, a subset of patients were undocumented immigrants or had undocumented family members, and we recognize that they may not have wanted to show on video their location during a telepsychology call. Similarly, patients and their families may not have wanted to show their homes on video either. By contrast, many patients were very open to telepsychology delivered via telephone if they had concerns about video.\nAs another inclusion‐related challenge, we realized that we needed to translate our telepsychology informed consent script into Spanish. Some of the clinics with whom we work did not have reliable translation services during this time, and therefore, our Spanish‐speaking doctoral trainees were providing care for those patients and their families who needed sessions in Spanish. Thus, we had our team of Spanish‐speaking clinicians translate and back‐translate our consent script, with their bilingual supervisor checking their work. Finally, as is true across the nation, many low‐income families include adults who were essential workers (e.g., in construction, food service, nursing). Thus, we found that our patients’ families were having to balance trying keep each other safe from any possible contamination when that person returned home, which, in turn, was contributing to the stress level of our patients and their families."}

LitCovid-sentences