Tele-oncology in the COVID-19 Era: The Way Forward?

Tele-oncology in the COVID-19 Era: The Way Forward?
Trends Cancer. 2020;6(7):547-549. doi:10.1016/j.trecan.2020.05.013

• COVID-19 has had a devastating impact on the care of cancer patients. Thus, tele-oncology has become a necessity to improve cancer care. Several organisations have issued guidelines for its use during COVID-19. Despite certain shortcomings, tele-oncology has great potential to help cancer patients during COVID-19 and in the future.
• Table 1: Summary of the Advantages and Disadvantages of Telehealth Technologies in Oncology

Tele-orthopaedics: A systematic mapping study

Tele-orthopaedics: A systematic mapping study
J Telemed Telecare. 2020;1357633X20919308. doi:10.1177/1357633X20919308

• Tele-orthopaedics is widely acknowledged for decreasing travel, time and cost, increasing accessibility and quality of care. 
• A systematic mapping to identify and classify the tele-orthopaedic applications and services concludes that telemonitoring (teleconsultation and telemetry) and telesurgery (telerobotics and telementoring) were found to be the two major forms of tele-orthopaedics. Mobile phones were used asynchronously in most of the teleconsultations. The development of different applications may result in the use of multiple smartphones applications in real-time teleconsultation.

Abstract

Tele-Critical Care: An Update From the Society of Critical Care Medicine Tele-ICU Committee.

Tele-Critical Care: An Update From the Society of Critical Care Medicine Tele-ICU Committee.
Crit Care Med. 2020 Apr;48(4):553-561. doi: 10.1097/CCM.0000000000004190.

• This article provides insight into tele-critical care's (TCC) evolving prevalence, functions, emerging trends, technologies, new applications, outcomes, and barriers. This term accommodates the concept that TCC services can be provided to locations beyond the physical confines of an ICU, or even a hospital.

Abstract:

Intensive Care Unit Telemedicine

Special issue on Intensive Care Unit Telemedicine,

Critical Care Clinics  July 2019

• Including:
• Telemedicine in Intensive Care Units: A Luxury or Necessity? [editorial]
• Intensive Care Unit Telemedicine in the Era of Big Data, Artificial Intelligence, and Computer Clinical Decision Support Systems. [Abstract]
• [Contact your local NHS library for a copy of articles from this journal]

Intensive Care Unit Telemedicine

Intensive Care Unit Telemedicine
Critical Care Clinics v35(3), July 2019

• A special issue dedicated to telemedicne in the ICU including:
• Intensive Care Unit Telemedicine in the Era of Big Data, Artificial Intelligence, and Computer Clinical Decision Support Systems p483-495

[Contact your local NHS Library for a copy of this journal]

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project.
BMJ Open Qual 2019;8:e000427. 8 April 2019. doi: 10.1136/bmjoq-2018-000427

• Findings from a pilot tele-clinic (telephone consultation) service for kidney transplant patients attending North Bristol NHS Trust Renal Unit shows that they are deliverable and well received by patients with a positive environmental impact and modest financial savings. 
• "It has the potential to be rolled out to other renal centres if a national tele-clinic tariff can be negotiated, and an integrated, appropriately reimbursed community phlebotomy system can be developed to facilitate remote monitoring of patients."

Abstract

Telemedicine in the ICU: clinical outcomes, economic aspects, and trainee education.

Telemedicine in the ICU: clinical outcomes, economic aspects, and trainee education
Curr Opin Anaesthesiol. 28 January 2019

• The value of tele-ICU to improve patient outcomes, optimize ICU bed utilization, increase financial performance and enhance educational opportunities for the next generation of providers has become more evident and differentiated in the last 2 years.

Abstract

Evaluating Tele-ICU Implementation Based on Observed and Predicted ICU Mortality

Evaluating Tele-ICU Implementation Based on Observed and Predicted ICU Mortality: A Systematic Review and Meta-Analysis
Crit Care Med. 24 January 2019

• After evaluating 13 included studies, tele-ICU implementation was associated with an overall reduction in ICU mortality.

Abstract

A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic.

A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic. [PubMed]

Ann R Coll Surg Engl. 2019 Jan;101(1):30-34.

• Clinical, financial and environmental benefits of  virtual urology clinic at Charing Cross Hospital, London.

Abstract

Determinants of ICUTelemedicine Effectiveness: An Ethnographic Study.

Determinants of Intensive Care Unit Telemedicine Effectiveness: An Ethnographic Study.
Am J Respir Crit Care Med. 2018 Oct 23. doi: 10.1164/rccm.201802-0259OC. [Epub ahead of print]

• A focused ethnographic evaluation of 10 ICU telemedicine programs using site visits, interviews, and focus groups in both facilities providing remote care and the target ICUs.
• Data analysis revealed three domains that influence ICU telemedicine effectiveness: leadership, perceived value and organizational characteristics.
• Location: Pennsylvania, United States

Clinical and Economic Outcomes of Telemedicine Programs in the ICU: A Systematic Review and Meta-Analysis

Clinical and Economic Outcomes of Telemedicine Programs in the Intensive Care Unit: A Systematic Review and Meta-Analysis [Abstract]
J Intensive Care Med. 2018 Jul;33(7):383-393. doi: 10.1177/0885066617726942.

• A systematic review identified 1035 studies of the impact of telemedicine programmes in ICU (Tele-ICU) (published 2000 -2016). 
• Pooled effects provided limited evidence that Tele-ICU approaches may reduce the ICU and hospital mortality, shorten the ICU length of stay, but have no significant effect in hospital length of stay. Implementation of Tele-ICU programs substantially costs and its long-term cost-effectiveness is still unclear.

Abstract

When Will Telemedicine Appear in the ICU?

When Will Telemedicine Appear in the ICU? [PubMed]
J Intensive Care Med. 2019 Apr; 34(4):271-276. doi: 10.1177/0885066618775956.

• This review examines the clinical evidence supporting the use of telemedicine in the ICU and discusses the impact on clinical efficacy and costs of care. Additionally, we review the current hurdles to more rapid adoption, including the significant financial investment, different models of care affecting the return on investment, and the varied cultural attitudes that impact the success and acceptance of care models using telemedicine in the ICU.

Abstract

Cost analysis of a speech pathology synchronous telepractice service for patients with head and neck cancer.

Cost analysis of a speech pathology synchronous telepractice service for patients with head and neck cancer.

Head Neck. 2017 Dec;39(12):2470-2480

• An Australian study of eighty-two referrals concludes that a synchronous telepractice service provides cost efficiencies over standard care for providing remote specialist speech pathology head and neck cancer intervention.

Abstract

Cystic fibrosis: diagnosis and management [NICE Guideline NG78]

Cystic fibrosis: diagnosis and management [NICE Guideline NG78]
NICE October 2017

• This guideline covers diagnosing and managing cystic fibrosis. Recommendations on: 
• diagnosis
• service delivery, including how to organise services and multidisciplinary teams
• annual and routine reviews
• monitoring, assessment and management, including for lung disease, pulmonary infection, distal intestinal obstruction syndrome, liver disease and cystic-fibrosis-related diabetes
• preventing cross-infection
• Tools to deliver the guideline are available.
• The guideline discusses the use of telemedicine for routine monitoring.