Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.34631/sporl.926 |
Resumo: | Introduction: The 2019 coronavirus disease (COVID-19) pandemic has led to profound restructuring in healthcare systems worldwide. Health institutions focused their resources on the approach to COVID-19 and activities were restricted in other areas. On the other hand, the use of telemedicine was stimulated, which consists of providing clinical and educational services remotely, but maintaining the interaction in real time, using audiovisual media. The specialty of Otorhinolaryngology (ENT) represents one of the many specialties whose clinical and surgical activities have undergone changes, due to the measures imposed. Objectives: We intend to assess the impact of COVID-19 on the provision of care and the use of telemedicine in ENT in Portugal, during the State of Emergency (march 22 to may 2, 2020), in the hope that these data may be useful as a future reference in future waves of COVID-19 or in a possible new public health threat, always aiming to improve the health care provision. Material and Methods: Application of an anonymous questionnaire, developed through the Google Forms tool and sent by e-mail to all Directors/Coordinators / of ENT Departments/Units in the country. The questionnaire comprises 35 questions with multiple or simple answers. Results: We obtained a 56.5% response rate to the questionnaire. Prior to the beginning of the pandemic, only 7.7% of the Departments used telemedicine, in the form of telephone contact and electronic medical prescription (EMP). In turn, during the State of Emergency, 84.6% started using telemedicine. During this period, 96.2% of the Departments maintained restricted clinical activity and 3.8% did not maintain any activity at all, with the majority maintaining less than 50% of their usual activity. Regarding the consultation and operating room activity, 96.2% of the Departments only performed urgent/oncological consultations and 80.8% only performed urgent surgeries/scheduled oncological pathology, with 3.8% not having any consultation and 19,2% had no surgical activity at all. Of all ENT Departments that participated in this study, 57.7% do not consider that there was an increase in contacts by patients during the State of Emergency. Once the COVID-19 pandemic has been overcome, 65.4% of the Departments considered they can implement/maintain the use of telemedicine in specific situations, namely, in most cases (82.4%) by telephone contact with the patient and EMP. In normal conditions, 46.2% consider that telemedicine in ENT adds quality to the service provided to patients, with 50% also considering that this modality improves access to healthcare and that it can be applied, in some situations, to specificities of ENT patients (57.7%). However, 73.1% consider that telemedicine is not applicable to most patients, due to literacy issues. Conclusions: The State of Emergency that prevailed in our country, due to the COVID-19 pandemic, changed the clinical practice in ENT, with the suspension of the presential elective activity in all ENT Departments, with a bet on telemedicine, as a way to allow the contact with these patients, maintaining only consultation and surgical treatment of urgent and oncological pathologies. This critical period may have stimulated a possible greater future use of telemedicine. However, the clinical impact of these changes on the quality of the service provided and on the health of patients has not been evaluated, so further studies are needed to investigate clinical results and possible health gains. |
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Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese realityImpacto da pandemia covid-19 na prestação de cuidados e na utilização da telemedicina em otorrinolaringologia: A realidade portuguesaCOVID-19SARS-CoV-2pandemictelemedicineotolaryngologyCOVID-19SARS-CoV-2pandemiatelemedicinaotorrinolaringologiaIntroduction: The 2019 coronavirus disease (COVID-19) pandemic has led to profound restructuring in healthcare systems worldwide. Health institutions focused their resources on the approach to COVID-19 and activities were restricted in other areas. On the other hand, the use of telemedicine was stimulated, which consists of providing clinical and educational services remotely, but maintaining the interaction in real time, using audiovisual media. The specialty of Otorhinolaryngology (ENT) represents one of the many specialties whose clinical and surgical activities have undergone changes, due to the measures imposed. Objectives: We intend to assess the impact of COVID-19 on the provision of care and the use of telemedicine in ENT in Portugal, during the State of Emergency (march 22 to may 2, 2020), in the hope that these data may be useful as a future reference in future waves of COVID-19 or in a possible new public health threat, always aiming to improve the health care provision. Material and Methods: Application of an anonymous questionnaire, developed through the Google Forms tool and sent by e-mail to all Directors/Coordinators / of ENT Departments/Units in the country. The questionnaire comprises 35 questions with multiple or simple answers. Results: We obtained a 56.5% response rate to the questionnaire. Prior to the beginning of the pandemic, only 7.7% of the Departments used telemedicine, in the form of telephone contact and electronic medical prescription (EMP). In turn, during the State of Emergency, 84.6% started using telemedicine. During this period, 96.2% of the Departments maintained restricted clinical activity and 3.8% did not maintain any activity at all, with the majority maintaining less than 50% of their usual activity. Regarding the consultation and operating room activity, 96.2% of the Departments only performed urgent/oncological consultations and 80.8% only performed urgent surgeries/scheduled oncological pathology, with 3.8% not having any consultation and 19,2% had no surgical activity at all. Of all ENT Departments that participated in this study, 57.7% do not consider that there was an increase in contacts by patients during the State of Emergency. Once the COVID-19 pandemic has been overcome, 65.4% of the Departments considered they can implement/maintain the use of telemedicine in specific situations, namely, in most cases (82.4%) by telephone contact with the patient and EMP. In normal conditions, 46.2% consider that telemedicine in ENT adds quality to the service provided to patients, with 50% also considering that this modality improves access to healthcare and that it can be applied, in some situations, to specificities of ENT patients (57.7%). However, 73.1% consider that telemedicine is not applicable to most patients, due to literacy issues. Conclusions: The State of Emergency that prevailed in our country, due to the COVID-19 pandemic, changed the clinical practice in ENT, with the suspension of the presential elective activity in all ENT Departments, with a bet on telemedicine, as a way to allow the contact with these patients, maintaining only consultation and surgical treatment of urgent and oncological pathologies. This critical period may have stimulated a possible greater future use of telemedicine. However, the clinical impact of these changes on the quality of the service provided and on the health of patients has not been evaluated, so further studies are needed to investigate clinical results and possible health gains. Introdução: A pandemia de doença coronavírus 2019 (COVID-19) provocou reestruturações profundas nos sistemas de cuidados de saúde em todo o mundo. As instituições de saúde concentraram os seus recursos na abordagem da COVID-19 e houve restrição de atividades em outras áreas. Por outro lado, foi estimulado o recurso à telemedicina, que consiste na prestação de serviços clínicos e educacionais remotamente, mas mantendo a interação em tempo real, através do recurso a meios audiovisuais. A especialidade de Otorrinolaringologia (ORL) representa uma das muitas especialidades cuja atividade clínica e cirúrgica sofreu alterações, em virtude das medidas impostas. Objetivos: Pretendemos avaliar o impacto da COVID-19 na prestação de cuidados e na utilização da telemedicina em ORL em Portugal, durante o Estado de Emergência (22 de março a 2 de maio de 2020), na esperança de que estes dados possam vir a ser úteis como referência futura em novas vagas da COVID-19 ou numa eventual nova ameaça de saúde pública, tendo sempre em vista a melhoria da prestação dos cuidados de saúde. Material e Métodos: Aplicação de um questionário anónimo, desenvolvido através da ferramenta Google Forms e enviado por correio eletrónico a todos os Diretores/Coordenadores de Serviços/Unidades de ORL do país. O questionário compreende 35 questões de resposta múltipla ou simples. Resultados: Obtivemos uma taxa de resposta ao questionário de 56,5%. Previamente ao início da pandemia, apenas 7,7% dos Serviços recorria à telemedicina, na forma de contacto telefónico e prescrição eletrónica médica (PEM). Por sua vez, durante o Estado de Emergência, 84,6% passaram a recorrer à telemedicina. Durante este período, 96,2% dos Serviços mantiveram atividade clínica com restrições e 3,8% não manteve qualquer atividade, sendo que a maioria manteve menos de 50% da sua atividade habitual. Relativamente à atividade de consulta e de bloco operatório, 96,2% dos Serviços apenas realizaram consulta urgente/oncológica e 80,8% apenas realizaram cirurgias de caráter urgente/ patologia oncológica programada, sendo que 3,8% não realizaram qualquer consulta e 19,2% não tiveram qualquer atividade cirúrgica. De todos os Serviços de ORL que participaram neste estudo, 57,7% não considerou que tivesse havido um aumento de contactos por parte dos doentes durante o Estado de Emergência. Uma vez ultrapassada a pandemia por COVID-19, 65,4% dos Serviços considera poder implementar/manter o recurso à telemedicina em situações específicas, nomeadamente, na maioria dos casos (82,4%) por contacto telefónico com o doente e PEM. Em condições de normalidade, 46,2% consideram que a telemedicina em ORL acrescenta qualidade ao serviço prestado aos doentes, com 50% a considerarem também que esta modalidade melhora o acesso aos cuidados de saúde e que pode ser aplicada, em algumas situações, a especificidades dos doentes do foro ORL (57,7%). No entanto, 73,1% consideram que a telemedicina não é aplicável à maioria dos doentes, por questões de literacia. Conclusões: O estado de emergência que vigorou no nosso país, devido à pandemia COVID-19, alterou a prática clínica em ORL, com a suspensão da atividade eletiva presencial em todos os Serviços, tendo havido uma aposta na telemedicina, como forma de permitir o contacto com estes doentes, mantendo-se presencial apenas a consulta clínica e o tratamento cirúrgico de patologias de caráter urgente e do foro oncológico. Este período crítico pode ter estimulado uma eventual maior utilização futura da telemedicina. Contudo, o impacto clínico destas alterações na qualidade do serviço prestado e na saúde dos doentes não foi avaliado, pelo que são necessários mais estudos com vista à investigação dos resultados clínicos e eventuais ganhos em saúde. Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço2021-06-09info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34631/sporl.926https://doi.org/10.34631/sporl.926Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery; Vol. 59 No. 2 (2021): June; 195-206Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço; Vol. 59 Núm. 2 (2021): Junho; 195-206Revista Portuguesa de Otorrinolaringologia-Cirurgia de Cabeça e Pescoço; Vol. 59 N.º 2 (2021): Junho; 195-2062184-6499reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://journalsporl.com/index.php/sporl/article/view/2882https://journalsporl.com/index.php/sporl/article/view/2882/904Direitos de Autor (c) 2021 Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoçoinfo:eu-repo/semantics/openAccessC. Gonçalves, Ana IsabelCarção, AndréDuarte , DelfimVilhena , Ditza2024-06-06T13:00:39Zoai:journalsporl.com:article/2882Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-06-06T13:00:39Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality Impacto da pandemia covid-19 na prestação de cuidados e na utilização da telemedicina em otorrinolaringologia: A realidade portuguesa |
title |
Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality |
spellingShingle |
Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality C. Gonçalves, Ana Isabel COVID-19 SARS-CoV-2 pandemic telemedicine otolaryngology COVID-19 SARS-CoV-2 pandemia telemedicina otorrinolaringologia |
title_short |
Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality |
title_full |
Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality |
title_fullStr |
Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality |
title_full_unstemmed |
Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality |
title_sort |
Impact of the covid-19 pandemic on care and on the use of telemedicine in otorhinolaryngology: The portuguese reality |
author |
C. Gonçalves, Ana Isabel |
author_facet |
C. Gonçalves, Ana Isabel Carção, André Duarte , Delfim Vilhena , Ditza |
author_role |
author |
author2 |
Carção, André Duarte , Delfim Vilhena , Ditza |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
C. Gonçalves, Ana Isabel Carção, André Duarte , Delfim Vilhena , Ditza |
dc.subject.por.fl_str_mv |
COVID-19 SARS-CoV-2 pandemic telemedicine otolaryngology COVID-19 SARS-CoV-2 pandemia telemedicina otorrinolaringologia |
topic |
COVID-19 SARS-CoV-2 pandemic telemedicine otolaryngology COVID-19 SARS-CoV-2 pandemia telemedicina otorrinolaringologia |
description |
Introduction: The 2019 coronavirus disease (COVID-19) pandemic has led to profound restructuring in healthcare systems worldwide. Health institutions focused their resources on the approach to COVID-19 and activities were restricted in other areas. On the other hand, the use of telemedicine was stimulated, which consists of providing clinical and educational services remotely, but maintaining the interaction in real time, using audiovisual media. The specialty of Otorhinolaryngology (ENT) represents one of the many specialties whose clinical and surgical activities have undergone changes, due to the measures imposed. Objectives: We intend to assess the impact of COVID-19 on the provision of care and the use of telemedicine in ENT in Portugal, during the State of Emergency (march 22 to may 2, 2020), in the hope that these data may be useful as a future reference in future waves of COVID-19 or in a possible new public health threat, always aiming to improve the health care provision. Material and Methods: Application of an anonymous questionnaire, developed through the Google Forms tool and sent by e-mail to all Directors/Coordinators / of ENT Departments/Units in the country. The questionnaire comprises 35 questions with multiple or simple answers. Results: We obtained a 56.5% response rate to the questionnaire. Prior to the beginning of the pandemic, only 7.7% of the Departments used telemedicine, in the form of telephone contact and electronic medical prescription (EMP). In turn, during the State of Emergency, 84.6% started using telemedicine. During this period, 96.2% of the Departments maintained restricted clinical activity and 3.8% did not maintain any activity at all, with the majority maintaining less than 50% of their usual activity. Regarding the consultation and operating room activity, 96.2% of the Departments only performed urgent/oncological consultations and 80.8% only performed urgent surgeries/scheduled oncological pathology, with 3.8% not having any consultation and 19,2% had no surgical activity at all. Of all ENT Departments that participated in this study, 57.7% do not consider that there was an increase in contacts by patients during the State of Emergency. Once the COVID-19 pandemic has been overcome, 65.4% of the Departments considered they can implement/maintain the use of telemedicine in specific situations, namely, in most cases (82.4%) by telephone contact with the patient and EMP. In normal conditions, 46.2% consider that telemedicine in ENT adds quality to the service provided to patients, with 50% also considering that this modality improves access to healthcare and that it can be applied, in some situations, to specificities of ENT patients (57.7%). However, 73.1% consider that telemedicine is not applicable to most patients, due to literacy issues. Conclusions: The State of Emergency that prevailed in our country, due to the COVID-19 pandemic, changed the clinical practice in ENT, with the suspension of the presential elective activity in all ENT Departments, with a bet on telemedicine, as a way to allow the contact with these patients, maintaining only consultation and surgical treatment of urgent and oncological pathologies. This critical period may have stimulated a possible greater future use of telemedicine. However, the clinical impact of these changes on the quality of the service provided and on the health of patients has not been evaluated, so further studies are needed to investigate clinical results and possible health gains. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-09 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34631/sporl.926 https://doi.org/10.34631/sporl.926 |
url |
https://doi.org/10.34631/sporl.926 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://journalsporl.com/index.php/sporl/article/view/2882 https://journalsporl.com/index.php/sporl/article/view/2882/904 |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço |
dc.source.none.fl_str_mv |
Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery; Vol. 59 No. 2 (2021): June; 195-206 Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço; Vol. 59 Núm. 2 (2021): Junho; 195-206 Revista Portuguesa de Otorrinolaringologia-Cirurgia de Cabeça e Pescoço; Vol. 59 N.º 2 (2021): Junho; 195-206 2184-6499 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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mluisa.alvim@gmail.com |
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