Telemedicine and e-Health Solutions for COVID-19: Patients' Perspective
2020; Mary Ann Liebert, Inc.; Volume: 26; Issue: 7 Linguagem: Inglês
10.1089/tmj.2020.0099
ISSN1556-3669
AutoresNina Pappot, Gry Assam Taarnhøj, Helle Pappot,
Tópico(s)Digital Mental Health Interventions
ResumoTelemedicine and e-HealthVol. 26, No. 7 OpinionFree AccessTelemedicine and e-Health Solutions for COVID-19: Patients' PerspectiveNina Pappot, Gry Assam Taarnhøj, and Helle PappotNina PappotFaculty of Health and Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Search for more papers by this author, Gry Assam TaarnhøjDepartment of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Search for more papers by this author, and Helle PappotAddress correspondence to: Helle Pappot, MD, DMSc, Department of Oncology 5073, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark E-mail Address: [email protected]Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Institute for Clinical Medicine, Faculty of Health, Copenhagen, Denmark.Search for more papers by this authorPublished Online:8 Jul 2020https://doi.org/10.1089/tmj.2020.0099AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail Like Telemedicine and eHealth, we think that "telemedicine and e-health alternatives can aid in controlling international pandemics."1 We comment on the possible psychological and sociological consequences of the pandemic itself and the solution hereof by telemedicine. One of the first publications on the role of telemedicine for COVID-19, published as a commentary in the New England Journal of Medicine and entitled "Virtually Perfect? Telemedicine for COVID-19," sparsely deals with this aspect.2 The authors focus on the important benefits of telemedicine for the health systems with respect to handling COVID-19 but leave out the patients' perspective. Similarly, Ting et al. have high expectations of digital technologies in their comment in Nature Medicine on March 27, 2020, with a focus especially on monitoring, surveillance, and detection and the potential for machine learning and artificial intelligence.3We agree that telemedicine has the potential to solve many issues in this situation, but to our knowledge, its potential has not yet described and taken into consideration from patients' perspective and nor are the possible great benefits of telemedicine well known. As seen from early data from China,4 many individuals will experience isolation during hospitalization or when quarantining at home. Research has described the many adverse effects of isolation in hospitalized patients,5 in particular anxiety and depression.6 Simple e-health tools may give severely ill COVID-19 patients the possibility of having peer-to-peer communication and easily obtaining relevant health information, probably leading to maintained quality of life and better mental health. We and other researchers within the e-health field have demonstrated the importance of e-health in avoiding feeling lonely and improving or maintaining quality of life during other severe illnesses,7 and this impact may also be of importance for patients and relatives dealing with COVID-19.The aim of this viewpoint is to draw attention to the ongoing importance of patient involvement in healthcare on an individual and organizational level when it comes to urgent e-health solutions for COVID-19. In this commentary, we show a group of e-health providers' perception of their tool's functionality according to e-health solutions for COVID-19, and comment on the solutions' possible use in the context of patient involvement.When searching the internet (using Google®) by using search terms such as "e-health solutions for COVID-19 and patient involvement," very sparse information can be found, and at present, it is not possible to perform literature searches due to very limited published results. However, a "hub" of e-health providers has undertaken the task of providing a global overview of the e-health solutions available for COVID-19.8 Solution providers, consultants advising the healthcare system, and healthcare professionals have been prompted on the internet to contribute with solutions for COVID-19. It has been the hub's aim that all the solutions should be made available across institutions, geographies, and countries. With the hub's permission, we present an overview of the assembled solutions, their functionality, and their distribution by country. Each of the solutions included has been validated by a steering group at the hub according to ease of implementation, COVID-19 impact, post-COVID-19 impact, dependency on external bottlenecks, and localization. The authors have reviewed the solutions with respect to their use for patient involvement during COVID-19.Thirty-eight (n = 38) different providers had their solution included in the hub's overview. In Table 1, eight different functionalities of the included solutions are displayed. Most solutions were Danish, as the hub was situated in Denmark, but in total, there were contributions from 12 different countries. Most solutions were on screening and triage (11/38) and remote patient monitoring (9/38). The hub has added a disclaimer that "it is a preliminary, living, non-exhaustive list compiled with high efforts within a short time frame." By reviewing the solutions, the authors have assessed, that with the exception of solutions for one functionality (supply storage), all solutions have the potential to involve patients. This can be either as individual patient involvement using e-health tools to secure better communication between patients and hospital staff, or as organizational patient involvement using patients' viewpoints to obtain e-health solutions, which integrates the healthcare systems needs and patients' needs, ensuring an improved outcome.Table 1. Functionality of e-Health Solutions for COVID-19 Showing Number of Providers per Functionality and Nationality of ProviderFUNCTIONALITIESNO. OF PROVIDERS OFFERING SOLUTIONS (N = 38)COUNTRY OF ORIGINCommunication64 Denmark1 Finland1 EgyptHygiene and personal protective equipment22 DenmarkMaintaining critical care32 Denmark1 FinlandRemote patient monitoring94 Finland3 Denmark1 United Kingdom/The Netherlands1 SwedenScreening and triage115 Denmark1 United States1 United Arabic Emirates1 Sweden1 China1 France1 SingaporeSupply storage11 DenmarkTraining11 DenmarkVirtual consultations53 Denmark1 Finland1 NorwayBased on our observations of case stories in the public media in which patients and relatives tell about their experiences during isolation and quarantine with COVID-19, our own experience from being healthcare professionals in this pandemic and experiences from previous research on e-health and patient involvement in other severe illnesses, we find it of importance to draw attention to the ongoing importance of patient involvement when it comes to urgent e-health solutions for COVID-19. We screened an e-health hub's list of possible functionalities for e-health tools during COVID-19 and found that for all but one (1/8) of the functionalities, patient involvement may be an element to improve the meaningfulness of the tool, to secure compliance and adherence, but most of all to integrate needs.We suggest and encourage healthcare systems that have the necessary technology to implement telemedicine or to go into cooperation with e-health providers, who have already developed accessible technologies, to be able to offer telemedicine to patients and their relatives. It is of importance that official public-health organizations take on this task, and Hernandez-Garcia et al.9 recently described the difference in information concerning the prevention of COVID-19, when found on websites from official public-health organizations versus digital media, in favor of official public-health organizations. This difference may also count for e-health solutions with patient involvement. Apart from all the logistic improvements and technological advantages, the implementation of e-health for COVID-19 will enable isolated individuals to receive timely information and to maintain a sense of social belonging. When this crisis is over, we must also remember to consider the social, organizational, and technological factors impacting both patients' and clinicians' adoption of mobile health tools, as Jacobs et al. has described for m-health in general,10 and patient involvement might be further needed to suggest usable and meaningful solutions. There is no time for hesitation. It is crucial to employ every possible tool to avoid feelings of loneliness, stress, and anxiety, which may even worsen physical symptoms. Hopefully, the COVID-19 pandemic can benefit from existing technologies and help solve patients' needs for information and ongoing social contact during isolation.Disclosure StatementThe authors report no conflicts of interest in this work.Funding InformationNo funding was received for this article.References1. Telemedicine and e-Health. Coronavirus hightlights urgent need for telehealth alternatives. 2020. Available at: https://home.liebertpub.com/spcoll/coronavirus-highlights-urgent-need-for-telehealth-alternativ/1111/ (last accessed April 11, 2020). Google Scholar2. Hollander JE, Carr BG. Virtually perfect? Telemedicine for COVID-19. N Engl J Med 2020. [Epub ahead of print]; doi.org/10.1056/NEJMp2003539. Google Scholar3. Ting DSW, Carin L, Dzau V, Wong TY. Digital technology and COVID-19. Nat Med 2020. [Epub ahead of print]; doi.org/10.1038/s41591-020-0824-5. Google Scholar4. Qiu H, Tong Z, Ma P, Hu M, Peng Z, Wu W, Du B; China Critical Care Clinical Trials Group (CCCCTG). Intensive care during the coronavirus epidemic. Intensive Care Med 2020;46:576–578. Crossref, Medline, Google Scholar5. Abad C, Fearday A, Safdar N. Adverse effects of isolation in hospitalised patients: a systematic review. J Hosp Infect 2010;76:97–102. Crossref, Medline, Google Scholar6. Catalano G, Houston SH, Catalano MC, Butera AS, Jennings SM, Hakala SM, Burrows SL, Hickey MG, Duss CV, Skelton DN, Laliotis GJ. Anxiety and depression in hospitalized patients in resistant organism isolation. South Med J 2003;96:141–145. Crossref, Medline, Google Scholar7. Pappot H, Assam Taarnhøj G, Elsbernd A, Hjerming M, Hanghøj S, Jensen M, Boisen KA. Health-related quality of life before and after use of a smartphone app for adolescents and young adults with cancer: pre–post interventional study. JMIR Mhealth Uhealth 2019;7:e13829. Crossref, Medline, Google Scholar8. Health Tech Hub Copenhagen. 2020. Available at: https://www.healthtechhub.org/ (last accessed April 11, 2020). Google Scholar9. Hernández-García I, Giménez-Júlvez T. Assessment of health information about COVID-19 prevention on the internet: infodemiological study. JMIR Public Health Surveill 2020;6:e18717. Crossref, Medline, Google Scholar10. Jacob C, Sanchez-Vazquez A, Ivory C. Social, organizational, and technological factors impacting clinicians' adoption of mobile health tools: systematic literature review. JMIR Mhealth Uhealth 2020;8:e15935. Crossref, Medline, Google ScholarFiguresReferencesRelatedDetailsCited byPatient Satisfaction with the Hybrid Telemedicine Model for Ophthalmology Manal Dia, Melanie M. Albrecht, Nedda Sanayei, Howard Cabral, Diana C. Martin, Manju L. Subramanian, Steven Ness, Nicole H. 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