Research Article
BibTex RIS Cite

AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH

Year 2022, Volume: 85 Issue: 1, 9 - 14, 25.01.2022

Abstract

Objective: In this study, we aimed to present the details of a successfully implemented telehealth model in a university hospital during the COVID-19 pandemic. Materials and Methods: Istanbul Faculty of Medicine (IFM) is a university hospital where the first confirmed case of COVID-19 in Turkey was detected. In IFM, patients who were diagnosed with COVID-19 and received outpatient or inpatient treatment were followed up by telehealth for 21-28 days after leaving the hospital. The distinguishing features of this service are the provision of remote outpatient clinical monitoring personally by physicians and the use of web-based IP information technologies. Results: Between March 15 and July 1, 2020, 1,042 individuals were followed up at least once, 860 patients for 21 days or more by the 26 physicians providing the telehealth service. A total of 11,736 calls were made by the physicians and 7,342 of those calls were answered and a total of 1,086 calls were made by patients. The median number of calls per patient was 4 (1-23). The median duration of the completed calls was 2.8 min (<1–50 min). During these follow-ups patients were informed about the importance of isolation. Most of the patients expressed their satisfaction with these follow-ups by thanking the calling physician. Conclusion: In a pandemic such as COVID-19, telehealth services may increase adherence to treatment and isolation precautions among patients with diseases that require follow-up without hospitalization after diagnosis. Telehealth will facilitate early recognition of symptoms that may require hospitalization, ensuring these patients receive the care they need. Therefore, this approach should be widely adopted.

References

  • 1. Koch S. Home telehealth-current state and future trends. Int J Med Inform 2006;75(8):565-76. [CrossRef]
  • 2. Stowe S, Harding S. Telecare, telehealth and telemedicine. Eur Geriatr Med 2010;1(3):193-7. [CrossRef]
  • 3. Moazzami B, Razavi-Khorasani N, Moghadem AD, Farokhi E, Razaei N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J Clin Virol 2020;126:104345. [CrossRef]
  • 4. Keshvardoost S, Bahaadinbeigy K, Fatehi F. Role of telehealth in the management of COVID-19:lessons learned from previous SARS, MERS, and Ebola outbreaks. Telemed J E Health 2020;26(7):850-2. [CrossRef]
  • 5. Lai CC, Liu YH, Wang CY, Wang YH, Hsueh SC, Yen MY, et al. Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2): facts and myths. J Microbiol Immunol Infect 2020;53(3):404-12. [CrossRef]
  • 6. Gao Z, Xu Y, Sun C, Wang X, Guo Y, Qiu S, et al., A systematic review of asymptomatic infections with COVID-19. J Microbiol Immunol Infect 2021;54(1):12-6. [CrossRef]
  • 7. Deziel NC, Allen JG, Scheepers PT, Levy JI. The COVID-19 pandemic: a moment for exposure science. J Expo Sci Environ Epidemiol 2020;30(4):591-3. [CrossRef]
  • 8. Türkiye Cumhuriyeti Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı, “Bilgi Toplumu Stratejisi (2006-2010)” ve “Bilgi Toplumu Stratejisi Eylem Planı (2006-2010)”. Available at http://www.bilgitoplumu.gov.tr/2014/bilgi-toplumustratejisi- 2006-2010/ Accessed on 11 Oct, 2020.
  • 9. Halk Sağlığı Genel Müdürlüğü, COVİD-19 Bilgilendirme Platformu, COVID-19 (SARS-CoV-2 Enfeksiyonu) Genel Bilgiler, Epidemiyoloji ve Tanı. Available at https://covid19. saglik.gov.tr/TR-66337/genel-bilgiler-epidemiyoloji-ve-tani. html Accessed on 1 Oct, 2020.
  • 10. Sağlık Hizmetleri Genel Müdürlüğü, Pandemi Hastaneleri. Available at https://shgmhastahakdb.saglik.gov.tr/Eklenti/ 36907/0/pandemi-hastaneleripdf.pdf Accessed on 1 June, 2020.
  • 11. Halk Sağlığı Genel Müdürlüğü, COVİD-19 Bilgilendirme Platformu, COVID-19 (SARS- CoV-2 Enfeksiyonu)Temaslı Takibi, Salgın Yönetimi, Evde Hasta İzlemi Filyasyon. Available at https://covid19.saglik.gov.tr/TR-66339/temaslitakibi- salgin-yonetimi-evde-hasta-izlemi-ve-filyasyon.html Accessed on 1 Oct, 2020.
  • 12. Halk Sağlığı Genel Müdürlüğü, COVİD-19 Bilgilendirme Platformu, COVID-19 (SARS-CoV-2 Enfeksiyonu) Erişkin Hasta Tedavisi. Available at https://covid19.saglik.gov.tr/ TR-66926/eriskin-hasta-tedavisi.html Accessed on 1 Oct, 2020.
  • 13. İstanbul Tıp Fakültesi, İstanbul Tıp Fakültesi Hastanesi Yeni Tip Koronavirüse (COVID-19) Karşı Tedbir ve Müdahale Çalışmaları. Available at https://cdn.istanbul.edu.tr/ FileHandler2.ashx?f=15062020-itf-hastanesi-bashekimlikraporu- 2.pdf Accessed on 1 July, 2020.
  • 14. Greenhalgh T, Koh GCH, Car J. Covid-19: a remote assessment in primary care. BMJ 2020;368:m1182. [CrossRef]
  • 15. Mann DM, Chen J, Chunara R, Testa PA, Nov O. COVID-19 transforms health care through telemedicine: evidence from the field. J Am Med Inform Assoc 2020;27(7):1132-5. [CrossRef]
  • 16. The Lancet, COVID-19: protecting health-care workers. Lancet 2020;395(10228):922. [CrossRef]
  • 17. Gerke S, Stern AD, Minssen T. Germany’s digital health reforms in the COVID-19 era: lessons and opportunities for other countries. npj Digital Medicine 2020;94(3):1-6. [CrossRef]
  • 18. Fisk M, Livingstone A, Pit SW. Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States. J Med Internet Res 2020;22(6):e19264. [CrossRef]

COVID-19 PANDEMİSİNDE HASTANE VE EVDE KONTROLLÜ HASTA YÖNETİMİ SAĞLAYAN ENTEGRE BİR MODEL: TELESAĞLIK

Year 2022, Volume: 85 Issue: 1, 9 - 14, 25.01.2022

Abstract

Amaç: Bu makalede bir üniversite hastanesinde COVID-19 pandemisi sırasında başarıyla uygulanmış olan telesağlık modelinin anlatılması amaçlanmıştır. Gereç ve Yöntem: İstanbul Tıp Fakültesi (İTF), Türkiye’de ilk doğrulanmış COVID-19 vakasının tespit edildiği bir üniversite hastanesidir. İTF’de COVID-19 tanısı almış ve ayaktan veya yatarak tedavisi düzenlenen hastaların hastaneden ayrılışından itibaren 21-28 günlük bir telesağlık izlemi yapılmıştır. Bu hizmetin örneklerinden farkı bizzat hekim tarafından uzaktan poliklinik izlemi olarak sunulmasıdır ve web-tabanlı, IP bilgi-iletişim teknolojisi kullanılmıştır. Bulgular: 15 Mart-1 Temmuz 2020 tarihleri arasında tele-sağlık hizmeti ile 1.042 kişinin en az bir izlemi yapılmış olup 860 hastanın ise 21 gün ve üzerinde izlemi 26 hekim tarafından gerçekleştirilmiştir. Hekimler tarafından bu süreçte toplam 11.736 çağrı yapılmış ve bu çağrıların 7.342’si cevaplanmıştır. Ayrıca hastalar tarafından da toplam 1.086 arama yapılmıştır. Hasta başına medyan arama sayısı 4 (1-23) ve tamamlanan aramaların medyan süresi 2,8 dakikaydı (<1-50 dakika). Bu izlemlerde hastalar izolasyonun önemi hakkında da bilgilendirilmiştir. Hastaların çoğu bu takiplerden memnuniyetini arayan hekime teşekkür ederek ifade ettiler. Sonuç: COVID-19 gibi bir pandemide telesağlık hizmetinin tanı sonrası hastaneye yatış olmaksızın takip edilebilecek hastalarda tedavi ve izolasyon önlemlerine uyumu arttıracağı söylenebilir. Telesağlık, hastaneye yatış gerektirebilecek semptomları erken fark edip bu hastaların ihtiyaç duydukları bakımı almalarını sağlayacaktır. Tüm bu durumlar göz önüne alındığında bu yaklaşım daha yaygın olarak benimsenmelidir.

References

  • 1. Koch S. Home telehealth-current state and future trends. Int J Med Inform 2006;75(8):565-76. [CrossRef]
  • 2. Stowe S, Harding S. Telecare, telehealth and telemedicine. Eur Geriatr Med 2010;1(3):193-7. [CrossRef]
  • 3. Moazzami B, Razavi-Khorasani N, Moghadem AD, Farokhi E, Razaei N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J Clin Virol 2020;126:104345. [CrossRef]
  • 4. Keshvardoost S, Bahaadinbeigy K, Fatehi F. Role of telehealth in the management of COVID-19:lessons learned from previous SARS, MERS, and Ebola outbreaks. Telemed J E Health 2020;26(7):850-2. [CrossRef]
  • 5. Lai CC, Liu YH, Wang CY, Wang YH, Hsueh SC, Yen MY, et al. Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2): facts and myths. J Microbiol Immunol Infect 2020;53(3):404-12. [CrossRef]
  • 6. Gao Z, Xu Y, Sun C, Wang X, Guo Y, Qiu S, et al., A systematic review of asymptomatic infections with COVID-19. J Microbiol Immunol Infect 2021;54(1):12-6. [CrossRef]
  • 7. Deziel NC, Allen JG, Scheepers PT, Levy JI. The COVID-19 pandemic: a moment for exposure science. J Expo Sci Environ Epidemiol 2020;30(4):591-3. [CrossRef]
  • 8. Türkiye Cumhuriyeti Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı, “Bilgi Toplumu Stratejisi (2006-2010)” ve “Bilgi Toplumu Stratejisi Eylem Planı (2006-2010)”. Available at http://www.bilgitoplumu.gov.tr/2014/bilgi-toplumustratejisi- 2006-2010/ Accessed on 11 Oct, 2020.
  • 9. Halk Sağlığı Genel Müdürlüğü, COVİD-19 Bilgilendirme Platformu, COVID-19 (SARS-CoV-2 Enfeksiyonu) Genel Bilgiler, Epidemiyoloji ve Tanı. Available at https://covid19. saglik.gov.tr/TR-66337/genel-bilgiler-epidemiyoloji-ve-tani. html Accessed on 1 Oct, 2020.
  • 10. Sağlık Hizmetleri Genel Müdürlüğü, Pandemi Hastaneleri. Available at https://shgmhastahakdb.saglik.gov.tr/Eklenti/ 36907/0/pandemi-hastaneleripdf.pdf Accessed on 1 June, 2020.
  • 11. Halk Sağlığı Genel Müdürlüğü, COVİD-19 Bilgilendirme Platformu, COVID-19 (SARS- CoV-2 Enfeksiyonu)Temaslı Takibi, Salgın Yönetimi, Evde Hasta İzlemi Filyasyon. Available at https://covid19.saglik.gov.tr/TR-66339/temaslitakibi- salgin-yonetimi-evde-hasta-izlemi-ve-filyasyon.html Accessed on 1 Oct, 2020.
  • 12. Halk Sağlığı Genel Müdürlüğü, COVİD-19 Bilgilendirme Platformu, COVID-19 (SARS-CoV-2 Enfeksiyonu) Erişkin Hasta Tedavisi. Available at https://covid19.saglik.gov.tr/ TR-66926/eriskin-hasta-tedavisi.html Accessed on 1 Oct, 2020.
  • 13. İstanbul Tıp Fakültesi, İstanbul Tıp Fakültesi Hastanesi Yeni Tip Koronavirüse (COVID-19) Karşı Tedbir ve Müdahale Çalışmaları. Available at https://cdn.istanbul.edu.tr/ FileHandler2.ashx?f=15062020-itf-hastanesi-bashekimlikraporu- 2.pdf Accessed on 1 July, 2020.
  • 14. Greenhalgh T, Koh GCH, Car J. Covid-19: a remote assessment in primary care. BMJ 2020;368:m1182. [CrossRef]
  • 15. Mann DM, Chen J, Chunara R, Testa PA, Nov O. COVID-19 transforms health care through telemedicine: evidence from the field. J Am Med Inform Assoc 2020;27(7):1132-5. [CrossRef]
  • 16. The Lancet, COVID-19: protecting health-care workers. Lancet 2020;395(10228):922. [CrossRef]
  • 17. Gerke S, Stern AD, Minssen T. Germany’s digital health reforms in the COVID-19 era: lessons and opportunities for other countries. npj Digital Medicine 2020;94(3):1-6. [CrossRef]
  • 18. Fisk M, Livingstone A, Pit SW. Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States. J Med Internet Res 2020;22(6):e19264. [CrossRef]
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section RESEARCH
Authors

Meryem Merve Ören 0000-0002-3383-7830

Nuray Özgülnar 0000-0002-1948-4194

Sevgi Canbaz 0000-0001-7960-4576

Selma Karabey 0000-0002-2964-3056

Ayşe Emel Önal 0000-0001-8321-6517

Mustafa Oral Öncül 0000-0002-1681-1866

Publication Date January 25, 2022
Submission Date May 6, 2021
Published in Issue Year 2022 Volume: 85 Issue: 1

Cite

APA Ören, M. M., Özgülnar, N., Canbaz, S., Karabey, S., et al. (2022). AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. Journal of Istanbul Faculty of Medicine, 85(1), 9-14.
AMA Ören MM, Özgülnar N, Canbaz S, Karabey S, Önal AE, Öncül MO. AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. İst Tıp Fak Derg. January 2022;85(1):9-14.
Chicago Ören, Meryem Merve, Nuray Özgülnar, Sevgi Canbaz, Selma Karabey, Ayşe Emel Önal, and Mustafa Oral Öncül. “AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH”. Journal of Istanbul Faculty of Medicine 85, no. 1 (January 2022): 9-14.
EndNote Ören MM, Özgülnar N, Canbaz S, Karabey S, Önal AE, Öncül MO (January 1, 2022) AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. Journal of Istanbul Faculty of Medicine 85 1 9–14.
IEEE M. M. Ören, N. Özgülnar, S. Canbaz, S. Karabey, A. E. Önal, and M. O. Öncül, “AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH”, İst Tıp Fak Derg, vol. 85, no. 1, pp. 9–14, 2022.
ISNAD Ören, Meryem Merve et al. “AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH”. Journal of Istanbul Faculty of Medicine 85/1 (January 2022), 9-14.
JAMA Ören MM, Özgülnar N, Canbaz S, Karabey S, Önal AE, Öncül MO. AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. İst Tıp Fak Derg. 2022;85:9–14.
MLA Ören, Meryem Merve et al. “AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH”. Journal of Istanbul Faculty of Medicine, vol. 85, no. 1, 2022, pp. 9-14.
Vancouver Ören MM, Özgülnar N, Canbaz S, Karabey S, Önal AE, Öncül MO. AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. İst Tıp Fak Derg. 2022;85(1):9-14.

Contact information and address

Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE

Email: itfdergisi@istanbul.edu.tr

Phone: +90 212 414 21 61