Glitches in the utilization of telehealth in pediatric rheumatology patients during the COVID-19 pandemic
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(2020) 18:78
COMMENTARY
Open Access
Glitches in the utilization of telehealth in pediatric rheumatology patients during the COVID-19 pandemic Nayimisha Balmuri1,2*
and Karen B. Onel1,2
Abstract Telehealth is an extraordinary advancement of modern medicine. It has increased access to care for underserved populations and, in the case of pediatric rheumatology, has expanded the reach of a limited work force. During the Coronavirus Disease 2019 (COVID-19) pandemic, telehealth has radically changed the way healthcare workers have been able to deliver care while maintaining social distance. In addition to the infectious havoc of COVID-19, the pandemic has further altered the psychosocial milleu of our society which directly impacts the wellness and safety of our pediatric rheumatology patients. These psychosocial factors may be difficult to assess and triage solely using telehealth. The objective of this short review is to educate practitioners on the psychosocial concerns exacerbated by the COVID-19 pandemic and to discuss the possible hurdles in utilization of telehealth to care for our vulnerable patient population. Keywords: Technology, Telehealth, Mental health, Psychosocial health, Adolescent health, COVID-19
Main text The workforce shortage of pediatric rheumatology practitioners in the United States has been well documented with many states remaining underserved without full time pediatric rheumatologists or a severely limited work force [1]. This has led to the adaptation of shared care models utilizing adult rheumatologists or community generalists, the use of mid-level practitioners, and most recently, the introduction of telehealth. Despite demonstrating feasibility and acceptability in studies, the uptake of telehealth within pediatric rheumatology has been slow due to a variety of reimbursement related concerns, and technical and regulatory obstacles [2]. The Coronavirus Disease 2019 (COVID-19) pandemic is a global medical emergency that has radically changed * Correspondence: [email protected] 1 Division of Pediatric Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA 2 Department of Pediatrics, NewYork Presbyterian/Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10065, USA
the way healthcare workers have been able to deliver care. Beginning in March, the Centers for Medicare and Medicaid Services in the US have increased resources to expand telehealth services and eliminated former barriers and requirements that would usually require in-person visits [3]. Similar changes have been noted internationally in an effort to triage potential COVID-19 patients and to provide convenient access to routine care while allowing for social distancing [4]. What this rapid surge in utilization of telehealth has shown the medical community is that this modality is effective as an emergency response and is a feasible option for patient monitoring. Therefore, the integration of telehealth into standard healthcare practices is likely to become permanent. Despite a
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