Articles: pandemics.
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"Beyond Just a Supplement": Administrators' Visions for the Future of Virtual Primary Care Services.
The COVID-19 pandemic resulted in unprecedented adoption and implementation of virtual primary care services, and little is known about whether and how virtual care services will be provided after the pandemic ends. We aim to identify how administrators at health care organizations perceive the future of virtual primary care services. ⋯ Health care organizations are considering how virtual primary care services can be used to improve patient outcomes, access to care, and convenience of care. To implement and sustain virtual primary care services, health care organizations will need long-term support from regulators and payers.
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The COVID-19 pandemic has made innovative solutions to providing safe, effective care paramount. eConsult allows primary care providers to access specialist advice for their patients without necessitating an in-person visit. This study aims to explain how an eConsult service adapted to providing care for COVID-19 patients and examine its impact on patient care. ⋯ Our study demonstrated the effectiveness of rapidly adapting eConsult for COVID-19 care and supports similar action for other services.
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The COVID-19 pandemic led to wide adoption of telehealth in primary care. The impact of telehealth on subsequent follow-up visit volume is mixed. This study examines the association of newly expanded telehealth with short-interval follow-up visits during the COVID-19 pandemic in an academic primary care practice. ⋯ Newly expanded telehealth visits conducted in the year after the onset of the COVID-19 pandemic resulted in higher rates and sooner first occurrence of short-interval follow-up visits. Future research should identify optimal scheduling processes for telehealth visits to minimize short-interval follow-ups.
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Loneliness is the subjective feeling people experience when they feel less socially connected to others than they desire. Beyond the impact to mental health and well-being, loneliness is linked to detrimental health outcomes. ⋯ Whether it be through in-person or virtual visits, primary care clinicians have tools and expertise to screen patients for loneliness, provide them supportive consultations, and refer persons with loneliness to helpful resources. As the societal changes from the pandemic continue to evolve, we recommend that primary care providers include loneliness screens as part of their standard workflow and consult with patients about effective interventions to reduce loneliness.
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National telehealth policy thus far has focused on broadening access to service, specialties, and originating sites. Yet telehealth policy can further equity by providing system-level change needed to reduce structural determinants that hamper telehealth access in historically marginalized, low income, and limited English-speaking populations. The authors propose policy solutions for states and CMS to help address these structural determinants of telehealth care. A telehealth "ecosystem" grounded in the following core components would ensure equitable access to care: use of technology inclusive of economically marginalized patients, access to the technology and broadband for completing virtual visits, and concrete support for patients as they develop their digital and telehealth skills.