A reflection on an adapted approach from face-to-face to telephone consultations in our Urology Outpatient Department during the COVID-19 pandemic - a pathway for change to future practice?

The sudden and unanticipated coronavirus disease 2019 (COVID-19) viral pandemic of 2020 and its profound impact on the NHS prompted an almost overnight change in the services we are able to offer our patients to fulfil clinical demands. From March 2020, we have changed outpatient appointments from face-to-face to telephone-led consultations. We have performed an early review of this service to ensure its sustainability during the unknown duration of this current crisis and to establish its potential utility when normal services resume in the future. Our present results show a patient satisfaction of 93%, with 83% happy to have telephone follow-up in the future, and a clinician satisfaction of 82% in the adequacy of the telephone consultation for making a clinical decision. Telephone clinics are a safe and efficient alternative to face-to-face outpatient consultations for many patients, particularly non-complex benign follow-ups.

Patel S ，Douglas-Moore J 《-》

Delivery of urological services (telemedicine and urgent surgery) during COVID-19 lockdown: experience and lessons learnt from a university hospital in United Kingdom.

Somani BK ，Pietropaolo A ，Coulter P ，Smith J ... -  《-》

SARS-CoV-2-related rapid reorganization of an epilepsy outpatient clinic from personal appointments to telemedicine services: A German single-center experience.

When the SARS-CoV-2 pandemic reached Europe in 2020, a German governmental order forced clinics to immediately suspend elective care, causing a problem for patients with chronic illnesses such as epilepsy. Here, we report the experience of one clinic that converted its outpatient care from personal appointments to telemedicine services. Documentations of telephone contacts and telemedicine consultations at the Epilepsy Center Frankfurt Rhine-Main were recorded in detail between March and May 2020 and analyzed for acceptance, feasibility, and satisfaction of the conversion from personal to telemedicine appointments from both patients' and medical professionals' perspectives. Telephone contacts for 272 patients (mean age: 38.7 years, range: 17-79 years, 55.5% female) were analyzed. Patient-rated medical needs were either very urgent (6.6%, n = 18), urgent (23.5%, n = 64), less urgent (29.8%, n = 81), or nonurgent (39.3%, n = 107). Outpatient service cancelations resulted in a lack of understanding (9.6%, n = 26) or anger and aggression (2.9%, n = 8) in a minority of patients, while 88.6% (n = 241) reacted with understanding, or relief (3.3%, n = 9). Telemedicine consultations rather than a postponed face-to-face visit were requested by 109 patients (40.1%), and these requests were significantly associated with subjective threat by SARS-CoV-2 (p = 0.004), urgent or very urgent medical needs (p = 0.004), and female gender (p = 0.024). Telemedicine satisfaction by patients and physicians was high. Overall, 9.2% (n = 10) of patients reported general supply problems due to SARS-CoV-2, and 28.4% (n = 31) reported epilepsy-specific problems, most frequently related to prescriptions, or supply problems for antiseizure drugs (ASDs; 22.9%, n = 25). Understanding and acceptance of elective ambulatory visit cancelations and the conversion to telemedicine consultations was high during the coronavirus disease 2019 (COVID-19) lockdown. Patients who engaged in telemedicine consultations were highly satisfied, supporting the feasibility and potential of telemedicine during the COVID-19 pandemic and beyond.

Willems LM ，Balcik Y ，Noda AH ，Siebenbrodt K ，Leimeister S ，McCoy J ，Kienitz R ，Kiyose M ，Reinecke R ，Schäfer JH ，Zöllner JP ，Bauer S ，Rosenow F ，Strzelczyk A ... -  《-》

The impact of the coronavirus (COVID-19) pandemic on elective paediatric otolaryngology outpatient services - An analysis of virtual outpatient clinics in a tertiary referral centre using the modified paediatric otolaryngology telemedicine satisfaction su

Virtual outpatient clinics (VOPC) have been integrated into both paediatric and based adult outpatient services due to a multitude of factors, including increased demand for services, technological advances and rising morbidity secondary to ageing populations. The novel coronavirus disease (COVID-19) has accentuated pressures on the National Health Service (NHS) infrastructure, particularly elective services, whilst radically altering patterns of practice. To evaluate the impact of the COVID-19 pandemic on paediatric otolaryngology outpatient services whilst collating patient feedback to elicit long-term sustainability post COVID-19. A retrospective analysis of VOPCs was undertaken at a tertiary paediatric referral centre over a 3-month capture period during the COVID-19 pandemic. Demographic, generic clinic (presenting complaint, new vs. follow-up, consultation type), as well as outcome data (medical or surgical intervention, discharge vs. ongoing review, onward referral, investigations, and conversion to face-to-face) was collated. Additionally a modified 15-point patient satisfaction survey was created. The Paediatric Otolaryngology Telemedicine Satisfaction survey (POTSS), was an adaptation of 4 validated patient satisfaction tools including the General Medical Council (GMC) patient questionnaire, the telehealth satisfaction scale (TESS), the telehealth usability questionnaire (TUQ), and the telemedicine satisfaction and usefulness questionnaire (TSUQ). Of 514 patients reviewed virtually over a 3-month period, 225 (45%) were randomly selected to participate, of which 200 met our inclusion criteria. The most common mode of consultation was telephony (92.5%, n = 185). Non-attendance rates were reduced when compared to face-to-face clinics during an equivalent period prior to the COVID-19 pandemic. A significant proportion of patients (29% compared to 26% pre-VOPC) were discharged to primary care. Nine percent were listed for surgery compared to 19% pre-VOPC. A subsequent face-to-face appointment was required in 10% of participants. Overall, the satisfaction when assessing the doctor-patient relationship, privacy & trust, as well as consultation domains was high, with the overwhelming majority of parents' content with the future integration and participation in VOPCs. An evolving worldwide pandemic has accelerated the need for healthcare services to reform in order to maintain a steady flow of patients within an elective outpatient setting without compromising patient care. Solutions must be sustainable long-term to account for future disruptions, whilst accounting for evolving patient demographics. Our novel survey has demonstrated the vast potential that the integration of VOPCs can offer paediatric otolaryngology services within a carefully selected cohort of patients.

Darr A ，Senior A ，Argyriou K ，Limbrick J ，Nie H ，Kantczak A ，Stephenson K ，Parmar A ，Grainger J ... -  《-》

Telephone consultation as a substitute for face-to-face consultation during the COVID-19 pandemic.

The health authorities have recommended that face-to-face consultations be substituted by telephone consultations to reduce the risk of virus transmission in out-patient clinics during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the present study was to assess the frequency of such telephone consultations and families' evaluations of them in a paediatric outpatient clinic during the initial weeks of the COVID-19 pandemic lockdown. During the period from 16 March to 23 April 2020, telephone consultations substituting face-to-face consultations in children and adolescents from 0 to 19 years of age were prospectively recorded. In subsequent telephone interviews, families were asked about their views on the telephone consultation. During the observation period, the clinic had 499 scheduled face-to-face appointments and 112 (22.4%) substitute telephone consultations. A total of 103 families participated in a telephone interview representing 87 (84.5%) children with atopic diseases and 16 (15.5%) with other conditions. A total of 100 (97.0%) of the families agreed or strongly agreed that they felt good about being offered a substitute telephone consultation; 14 (13.6%) said that a telephone consultation was not the best option, whereas 89 (80.4%) would not have preferred a face-to-face consultation; 98 (95.1%) felt that the telephone consultation was useful to them. A minority of planned face-to-face consultations was substituted by telephone consultations during the COVID-19 pandemic lockdown. Families were satisfied with substitute telephone consultations. none. not relevant.

Wolthers TO ，Wolthers OD 《-》