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The Direction of Neurosurgery to Overcome the Living with COVID-19 Era : The Possibility of Telemedicine in Neurosurgery

  • Min Ho Lee (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, School of Medicine, The Catholic University of Korea) ;
  • Seu-Ryang Jang (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, School of Medicine, The Catholic University of Korea) ;
  • Tae-Kyu Lee (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, School of Medicine, The Catholic University of Korea)
  • Received : 2022.09.19
  • Accepted : 2023.01.04
  • Published : 2023.09.01

Abstract

Objective : Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited. Methods : The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire. Results : During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor's explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time. Conclusion : In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.

Keywords

References

  1. Alessa T, Hawley MS, Hock ES, de Witte L : Smartphone apps to support self-management of hypertension: review and content analysis. JMIR Mhealth Uhealth 7 : e13645, 2019
  2. Ashrafzadeh S, Hamdy O : Patient-driven diabetes care of the future in the technology era. Cell Metab 29 : 564-575, 2019 https://doi.org/10.1016/j.cmet.2018.09.005
  3. Chan JCN, Lim LL, Wareham NJ, Shaw JE, Orchard TJ, Zhang P, et al. : The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet 396 : 2019-2082, 2021
  4. Chen J, Sun D, Zhang S, Shi Y, Qiao F, Zhou Y, et al. : Effects of homebased telerehabilitation in patients with stroke: a randomized controlled trial. Neurology 95 : e2318-e2330, 2020 https://doi.org/10.1212/WNL.0000000000010821
  5. Chuo J, Macy ML, Lorch SA : Strategies for evaluating telehealth. Pediatrics 146 : e20201781, 2020
  6. de Jong MJ, van der Meulen-de Jong AE, Romberg-Camps MJ, Becx MC, Maljaars JP, Cilissen M, et al. : Telemedicine for management of inflammatory bowel disease (myIBDcoach): a pragmatic, multicentre, randomised controlled trial. Lancet 390 : 959-968, 2017 https://doi.org/10.1016/S0140-6736(17)31327-2
  7. Eichberg DG, Basil GW, Di L, Shah AH, Luther EM, Lu VM, et al. : Telemedicine in neurosurgery: lessons learned from a systematic review of the literature for the COVID-19 era and beyond. Neurosurgery 88 : E1-e12, 2020
  8. Jang S, Kim D, Yi E, Choi G, Song M, Lee EK : Telemedicine and the use of Korean medicine for patients with COVID-19 in South Korea: observational study. JMIR Public Health Surveill 7 : e20236, 2021
  9. Jung EY, Kang HW, Park IH, Park DK : Proposal on the establishment of telemedicine guidelines for Korea. Healthc Inform Res 21 : 255-264, 2015 https://doi.org/10.4258/hir.2015.21.4.255
  10. Kahn EN, La Marca F, Mazzola CA : Neurosurgery and telemedicine in the United States: assessment of the risks and opportunities. World Neurosurg 89 : 133-138, 2016 https://doi.org/10.1016/j.wneu.2016.01.075
  11. Kim HS : Towards telemedicine adoption in Korea: 10 practical recommendations for physicians. J Korean Med Sci 36 : e103, 2021
  12. Lee MH, Jang SR, Lee TK : Comparative analysis of COVID-19 outbreak and changes in neurosurgical emergency patients. J Korean Neurosurg Soc 65 : 130-137, 2022 https://doi.org/10.3340/jkns.2021.0056
  13. Majmundar N, Ducruet AF, Wilkinson DA, Catapano JS, Patel J, Baranoski JF, et al. : Telemedicine for endovascular neurosurgery consultation during the COVID-19 era: patient satisfaction survey. World Neurosurg 158 : e577-582, 2021
  14. Mouchtouris N, Lavergne P, Montenegro TS, Gonzalez G, Baldassari M, Sharan A, et al. : Telemedicine in neurosurgery: lessons learned and transformation of care during the COVID-19 pandemic. World Neurosurg 140 : e387-e394, 2020 https://doi.org/10.1016/j.wneu.2020.05.251
  15. Olson CA, McSwain SD, Curfman AL, Chuo J : The current pediatric telehealth landscape. Pediatrics 141 : e20172334, 2018
  16. Omboni S, Caserini M, Coronetti C : Telemedicine and M-health in hypertension management: technologies, applications and clinical evidence. High Blood Press Cardiovasc Prev 23 : 187-196, 2016 https://doi.org/10.1007/s40292-016-0143-6
  17. Omboni S, McManus RJ, Bosworth HB, Chappell LC, Green BB, Kario K, et al. : Evidence and recommendations on the use of telemedicine for the management of arterial hypertension: an international expert position paper. Hypertension 76 : 1368-1383, 2020 https://doi.org/10.1161/HYPERTENSIONAHA.120.15873
  18. Tchero H, Tabue Teguo M, Lannuzel A, Rusch E : Telerehabilitation for stroke survivors: systematic review and meta-analysis. J Med Internet Res 20 : e10867, 2018
  19. Tuckson RV, Edmunds M, Hodgkins ML : Telehealth. N Engl J Med 377 : 1585-1592, 2017 https://doi.org/10.1056/NEJMsr1503323
  20. Wang Y, Xue H, Huang Y, Huang L, Zhang D : A systematic review of application and effectiveness of mHealth interventions for obesity and diabetes treatment and self-management. Adv Nutr 8 : 449-462, 2017 https://doi.org/10.3945/an.116.014100