LitCovid-sentences  

PMC:7536914 / 151-6249 JSONTXT 10 Projects

Annnotations TAB TSV DIC JSON TextAE

Id Subject Object Predicate Lexical cue
T4 0-76 Sentence denotes The COVID‐19 pandemic has necessitated rapid changes in healthcare delivery.
T5 77-260 Sentence denotes Historically, uptake of virtual health care (VH) has been low, especially in specialized clinics; for example, 0.5% of all billable services were provided virtually in Canada in 2015.
T6 261-522 Sentence denotes 1 Prior to March 2020, fewer than 5% of all patient visits in our clinic were by VH utilizing our health authority's approved platform; however, this platform required the patient to attend a remote healthcare facility, clearly undesirable during the pandemic.
T7 523-582 Sentence denotes We trialed various platforms including FaceTime® and Zoom®.
T8 583-708 Sentence denotes Barriers existed with both platforms such as specific device requirements, poor technology literacy, and/or privacy concerns.
T9 709-879 Sentence denotes Ultimately, our clinic adopted a web‐based platform (Doxy.me®) that allows for videoconferencing with end‐to‐end encryption between healthcare provider (HCP) and patient.
T10 880-1086 Sentence denotes Over the span of 2 weeks, our clinic transitioned to providing more than 90% of patient care utilizing VH, while maintaining usual clinic capacity of approximately 10 post‐transplant patient visits per day.
T11 1087-1224 Sentence denotes Patients transplanted within the previous 3 months and patients with unstable respiratory symptoms were prioritized for in‐person visits.
T12 1225-1357 Sentence denotes Our clinic cares for >300 lung transplant recipients over an extended geography in western Canada; all patients are eligible for VH.
T13 1358-1418 Sentence denotes Usual clinic workflow was modified to adapt to VH (Table 1).
T14 1419-1647 Sentence denotes Human resource modifications were negligible after implementation of VH; our clinic has 3.5 transplant coordinators (RNs), 1 MD per clinic day, and 1 PharmD; no additional support staff was needed during or after implementation.
T15 1648-1803 Sentence denotes Post‐visit satisfaction surveys adapted from Sidhu et al 2 were completed immediately following VH visits, these surveys are Research Ethics Board exempt.
T16 1804-1961 Sentence denotes After 6 weeks of data collection, 157 physician surveys were returned; 70% of visits have taken place by videoconference with the remaining 30% by telephone.
T17 1962-2041 Sentence denotes Physicians reported being satisfied or very satisfied with VH over 90% of time.
T18 2042-2134 Sentence denotes Physician dissatisfaction was often a result of missing or incomplete blood work or imaging.
T19 2135-2204 Sentence denotes Technical problems interfered with care goals in only 2.5% of visits.
T20 2205-2332 Sentence denotes In the same time period, 45 patient surveys were received, 71% from patients who live more than 150 kilometers from the clinic.
T21 2333-2451 Sentence denotes Compared to usual care, 91% of patients reported that the virtual visit was as good as or better than in‐person visit.
T22 2452-2633 Sentence denotes Fear of substandard care with VH compared to usual care, and lack of social interaction with other clinic patients and staff were identified by multiple patients as drawbacks of VH.
T23 2634-2846 Sentence denotes The median estimated out‐of‐pocket expense saved per VH visit compared with in‐person visits was CAN $75 per patient (range $0‐$1250), and the median estimated amount of time saved was 9 hours (range 0‐92 hours).
T24 2847-2934 Sentence denotes Table 1 Comparison of workflow between in‐person and virtual patient care appointments
T25 2935-2966 Sentence denotes Clinic Type In‐person Virtual
T26 2967-3018 Sentence denotes Routine pre‐clinic Investigation Performed locally
T27 3019-3095 Sentence denotes Specialized investigations performed at transplant center Performed locally
T28 3096-3125 Sentence denotes No specialized investigations
T29 3126-3201 Sentence denotes Clinic visit Spirometry performed on site immediately prior to appointment
T30 3202-3292 Sentence denotes Nursing assessment including vital signs, review of systems, and medication reconciliation
T31 3293-3509 Sentence denotes Pharmacist and physician assessment, including physical examination and documentation to health record Nurse reviews patient‐reported vital signs and home spirometry, review of systems, and medication reconciliation
T32 3510-3639 Sentence denotes Pharmacist and physician assessment, including modified physical examination (inspection only) and documentation to health record
T33 3640-3682 Sentence denotes Follow‐up Performed locally when possible
T34 3683-3749 Sentence denotes Telephone follow‐up when possible Performed locally when possible
T35 3750-3794 Sentence denotes Telephone or virtual follow‐up when possible
T36 3795-3942 Sentence denotes John Wiley & Sons, Ltd This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response.
T37 3943-4125 Sentence denotes It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.
T38 4126-4306 Sentence denotes Many barriers exist to successful implementation of VH for lung transplant patients given their frequent need for blood work, imaging, and pulmonary function testing or spirometry.
T39 4307-4506 Sentence denotes In our case, these challenges were mostly mitigated by a provincial electronic medical record for laboratory and radiology reporting, allowing patients to have testing performed in their local areas.
T40 4507-4630 Sentence denotes Clinic spirometry and pulmonary function testing were deferred when possible at the discretion of the transplant physician.
T41 4631-4759 Sentence denotes Virtual health care has been shown to be effective for management of a number of conditions including lung transplant follow‐up.
T42 4760-4937 Sentence denotes 2 , 3 However, concerns with privacy continue to be a consideration, as does the inability for physicians to physically examine the patient, which may lead to suboptimal care.
T43 4938-5069 Sentence denotes While this has not been demonstrated in the literature, few, if any, studies have been powered to capture this type of information.
T44 5070-5216 Sentence denotes There is no literature evaluating the outcomes of rapid implementation of VH in lung transplant patients as necessitated by the COVID‐19 pandemic.
T45 5217-5319 Sentence denotes Virtual health care will play a greater role in post‐transplant care even after the COVID‐19 pandemic.
T46 5320-5491 Sentence denotes Patients, HCPs, and health systems are likely to demand increased access to VH to reduce cost and time spent accessing care, and to improve the overall patient experience.
T47 5492-5670 Sentence denotes The greatest challenges associated with VH at this time appear to be technological barriers including inadequate technological infrastructure as well as poor technology literacy.
T48 5671-5762 Sentence denotes 4 Investment in improved VH infrastructure is needed to enable system‐wide implementation.
T49 5763-5915 Sentence denotes Our preliminary data demonstrate that VH can be rapidly implemented in lung transplant clinics with a high degree of patient and physician satisfaction.
T50 5916-6098 Sentence denotes Research is ongoing to identify the optimal patients and circumstances for whom VH‐based post‐transplant care may be implemented in the long term using objective clinical end points.