Covid-19 Related Disruption of Out-Patient Services: An Opportunity for Integrating Telemedicine into Clinical Practice in Public Hospitals in Nigeria
##article.abstract##
The number of cases of COVID-19 disease has rapidly escalated worldwide causing widespread socio-economic disruptions as goverrnments enforced strict movement restriction (lockdown) measures to contain its spread. Because hospitals were also considered high risk areas for transmission of the disease, several measures were introduced in hospitals worldwide, Nigeria inclusive, to limit non-essential visits to the hospitals and reduce healthcareworker-patient interractions to only what is necesssary. Such measures included the complete or partial closure of Outpatient departments in many public hospitals with the attendant deleterious effects of disruption of patients’ care plans, lack of access to physician attention, counselling and prescription refills.
With the easing of the lockdown nationwide, most public hospitals yet to return to pre-lockdown free- flowing patient care arrangements especially in the outpatient clinics either due to reduction in total number of patients accommodated in new physical-distancing inspired arrangements or delays in accessing care due to unwieldy triage processses. This has led to significant difficulties for patients. In the face of this, and the spate of rising cases of COVID-19 infections in Nigeria and worldwide, we propose that Telemedicine should be introduced into outpatient consultations in Nigeria. We propose a model for involving Telemedicine in the outpatient care of patients side-by-side the usual physical consultation. Our model proposes telesmart triage and identification of patients who may benefit from Teleconsultation so as to reduce the pressure on healthcareworker-patient interraction. This will reduce the risk of transmission of COVID-19 to healthcareworkers and reducing the cost of personal protective equipment.
##submission.citations##
Adebayo PB, Jusabani A, Mukhtar M, Zehri AA (2020). The changing trend of teleconsultations during COVID-19 era at a tertiary facility in Tanzania. Pan African Medical Journal 35(2): 125.
Blue R, Yang AI, Zhou C, De Ravin E, Teng CW, Arguelles GR, Huang V, Wathen C, Miranda SP, Marcotte P, Malhotra NR, Welch WC, Lee JYK (2020). Telemedicine in the Era of Coronavirus Disease 2019 (COVID-19): A Neurosurgical Perspective. World Neurosurgery 139:549-57.
Clarke G, Pariza P, Wolters A. (n.d.) (2020): How has COVID-19 affected service delivery in GP practices that offered remote consultations before the pandemic? The Health Foundation. Retrieved August 15, 2020 from https://www.health.org.uk/news-and-comment/charts-and-infographics/how-has-covid-19-affected-service-delivery-in-gp-practices.
COVID-19 South Africa (2020): Pandemic and Telemedicine.(n.d.) Retrieved August 16, 2020 from Clyde & co. website, https://www.clydeco.com/en/insights/2020/04/covid-19-south-africa-pandemic-and-telemedicine
David KB, Solomon JK, Yunusa I, Lawal BK, Marshal CS, Okereke M,et al (2020). Telemedicine: an imperative concept during COVID-19 pandemic in Africa. Pan African Medical Journal 35: 129
Gadjradj PS, Matawlie RH, Harhangi BS (2020).The Use of Telemedicine by Neurosurgeons During the COVID Era: Preliminary Results of a Cross-Sectional Research. World neurosurgery 139:746-8.
Glazer E, Marshall C, Cunningham N (1978). Remote pediatric consultation in the inner city: television or telephone? Am J Public Health. 68:1133-1135.
Hassibian MR, Hassibian S (2016). Telemedicine acceptance and implementation in developing countries: benefits, categories, and barriers. Razavi Int J Med. 4(3):e38332.
Jayawardena ADL, Mankarious LA, Keamy DG, Jr., Cohen MS (2020). Pediatric, Family-Centered, "At-Home" Otologic Physical Examination in the COVID-19 Era. Otolaryngology-Head and Neck Surgery 0194599820934776.
Kiberu VM, Scott RE, Mars M (2019). Assessing core, e-learning, clinical and technology readiness to integrate telemedicine at public health facilities in Uganda: a health facility - based survey. BMC Health Serv Res. 19(1):266. doi: 10.1186/s12913-019-4057-6.
Lin JC, Humphries MD, Shutze WP, Aalami OO, Fischer UM, Hodgson KJ (2020). Telemedicine Platforms and Their Use in the Coronavirus Disease-19 Era to Deliver Comprehensive Vascular Care. Journal of Vascular Surgery 2020 https://doi.org/10.1016/j.jvs.2020.06.051.
McGinley MP, Ontaneda D, Wang Z, Weber M, Shook S, Stanton M et al (2020). Teleneurology as a Solution for Outpatient Care During the COVID-19 Pandemic. Telemed J E Health. Jun 16.
Nanda K, Lebetkin E, Steiner MJ, Yacobson I, Dorflinger LJ (2020). Contraception in the Era of COVID-19. Global health, Science and Practice 8:166-8.
Song X, Liu X, Wang C (2020). The role of telemedicine during the COVID-19 epidemic in China - Experience from Shandong province. Crit Care. 24(1):178.
Tanaka MJ, Oh LS, Martin SD, Berkson EM (2020): Telemedicine in the Era of COVID-19: The Virtual Orthopaedic Examination. The Journal of Bone and Joint Surgery American 102:e57.
Worldometer COVID-19 Pandemic. (n.d.) (2020). Retrieved August 17, 2020 from https://www.worldometers.info/coronavirus/
Zweig S (2020). Patient-Doctor Telemedicine: Virtual Care in the Era of COVID-19 and Beyond. Missouri medicine 117:175-6.
##submission.downloads##
##submissions.published##
##issue.issue##
##section.section##
##submission.license##
##submission.copyrightStatement##
##submission.license.cc.by4.footer##