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Otolaryngology in the time of COVID : An overview of common open‐source telemedicine platforms

2020; Wiley; Volume: 5; Issue: 5 Linguagem: Inglês

10.1002/lio2.454

2378-8038

Douglas M. Hildrew, Kim Chang Sing Pang, Daniel L. Faden,

Telemedicine and Telehealth Implementation

While the practice of medicine has existed for centuries, it has been exceedingly resistant to change. Unlike a virus which is constantly changing from within, medicine has survived by changing its surroundings. Intellectual, diagnostic, and therapeutic advances have brought medicine out of the dark ages and into the modern era. But at its core, the physician-patient relationship had always started and ended with the proverbial handshake until now. The year 2020 will forever be remembered in medicine. It is the year the handshake became feared, and the year that medicine was finally forced to change from within. For the first time, physicians and patients alike are seeking ways to rapidly restructure the time-honored physician-patient relationship. As the global severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) pandemic made social distancing a necessity, patients began to question the safety of their surroundings. Where the doctor's office was once a place that patients visited to improve their health, it became feared by some as a source of potential disease. But how does one take the doctor out of the doctor's office? The answer is simple, you take away the office. While telemedicine has allowed physicians unprecedented access to their patients, it represents a drastic shift in centuries worth of tradition. Physicians are now tasked with triaging, then potentially diagnosing and treating patients all without ever having performed a manual physical evaluation. This sudden shift in medical practice has forced many health care providers into using one of the numerous available telehealth platforms. Here, we present an overview of the most commonly used electronic medical recored based (EMR-based) and non-EMR based options in telehealth video platforms. All options discussed are either compliant with the health insurance portability and accountability act (HIPAA) or HIPAA approved, and represent viable systems to rapidly begin instituting telemedicine services during the global pandemic. While some of the platforms discussed are short-time solutions only allowed as a result of waivers from the centers for medicare and medicaid services (CMS) and HIPPA, others are more formal long-term solutions (Tables 1-3). Mac OS X with Mac OS 10.6.8 (Snow Leopard) or later Windows XP with SP3 or later Ubuntu 12.04, Mint 17.1, Red Hat Enterprise Linux 6.4, Oracle Linux 6.4, CentOS 6.4, Fedora 21, OpenSUSE 13.2, and ArchLinux (64-bit only) or later iOS 8.0 or later iPadOS 13 or later Android 5.0x or later Mac OS X 10.10 or later Windows 10 or later 64-bit Ubuntu 14.04+ 64-bit Debian 8.0+ 64-bit OpenSUSE 13.3+ 64-bit Fedora Linux 24+ iOS 8 or later Android 4 (Ice Cream Sandwich) or later iOS 10.0 or later Android not specified iOS 8.0 or later iPadOS 13 or later Android 5.0x or later Android OS 4.0.4. or later iOS 10.0 or later On desktop Skype for Web can be used on Microsoft Edge and Google Chrome without needing the app For mobile devices the Skype app is required. On desktop Skype for Web can be used on Microsoft Edge and Google Chrome For mobile devices the Skype app is required. 100 participants 1000 participants with the Large Meeting add-on Free A Google G Suite account is available from $6–$25/month Free Extension packages are available from $13.99/month Windows 10 SAC, 8.1, Server 2016, or Server 2019 The latest three versions of macOS Windows 8.1, 10, or Server 2012 R2+ Mac OS X 10.11 El Capitan or later Linux distributions capable of installing DEB or RPM Mac OS X with Mac OS 10.6.8 (Snow Leopard) or later Windows XP with SP3 or later Ubuntu 12.04, Mint 17.1, Red Hat Enterprise Linux 6.4, Oracle Linux 6.4, CentOS 6.4, Fedora 21, OpenSUSE 13.2, ArchLinux (64-bit only) or later iOS 6.0 or later Android 4.0 or later iOS 8.0 or later iPadOS 13 or later Android 5.0x or later iOS 11.0 or later Android 5.0 or later Yes, the software is often included or available in the Office 365 package Mobile devices require the Skype for Business app. No Google Meet works entirely through supported browsers (Google Chrome, Mozilla Firefox, Microsoft Edge, Safari) Mobile devices require the Google Meet app 100 participants for G Suite Education, Basic, and Business 250 participants for G Suite Enterprise and Enterprise of Education. Windows 7 or later Mac OS X 10.11 or later iOS 11 or later Android 5.0 or later iOS 11.0 or later Android 6.0 or later For desktop Video calling works through web browsers (Google Chrome, Safari, Mozilla Firefox) For mobile devices the Doximity app is required The free version includes unlimited minutes and one-on-one sessions Professional Doxy.me ($35/month) offers SD- and HD-video and audio-only for one-on-one calls Clinic Doxy.me ($50/month) allows group calls, simultaneous calls, and Teleconsent While there are no perfect telemedicine platforms currently available, there are many existing options that can be easily adapted to suit the needs of the otolaryngologist. Potential options span the range of large electronic medical record-based platforms to simple application-based platforms that can be used on a smart phone or tablet device. We encourage otolaryngologists to keep an open mind about which telemedicine platform they embrace, as short-term needs and long-term goals for a telemedicine interface may differ. In addition, regional basis may influence which software patients are most familiar with and/or comfortable with. The authors declare no potential conflict of interest.