Elsevier

Journal of Voice

Volume 36, Issue 3, May 2022, Pages 396-402
Journal of Voice

Implementation of Telemedicine in a Laryngology Practice During the COVID-19 Pandemic: Lessons Learned, Experiences Shared

https://doi.org/10.1016/j.jvoice.2020.06.017Get rights and content

Summary

Objectives

The novel coronavirus disease 2019 has posed significant limitations and barriers to providing in-person healthcare. We aim to provide a summary of learned experiences and important considerations for implementing and offering telehealth to provide laryngology subspecialty care during the COVID-19 pandemic and thereafter.

Materials and Methods

Four laryngologists and a voice-specialized speech-language pathologist from a tertiary-care academic Voice and Swallowing Center were engaged in a structured group consensus conference. Participants shared input, experiences, and practice patterns employed via telemedicine (via telephone or video-communication) during the early COVID-19 era.

Results

Key identified areas of consideration when offering telemedicine included (1) how to set up and structure a telemedicine visit and maintain patient confidentiality, (2) patient examination and treatment initiation, (3) optimization of the tele-visit, (4) limitations and recognition of when a tele-visit is insufficient for patient care needs, (5) billing/reimbursement considerations. Group consensus for the aforementioned topics is summarized and discussed.

Conclusion

During the COVID-19 pandemic, a telemedicine model can be effectively employed to improve patient access to subspecialty laryngology care, including a multidisciplinary care approach, with initiation of various therapeutic interventions. A major limitation given the preclusion of in-person assessment is the lack of access to laryngoscopy, which can likely be delayed safely in the majority of individuals.

Key Words

Telemedicine
Laryngology
COVID-19
Video visit
Coronavirus
SARS-CoV-2
Abbreviations: COVID-19
Coronavirus disease 2019
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
PPI
Personal protective equipment
SLP
Speech-language pathologist
UCSF
University of California, San Francisco
PROM
Patient reported outcome measure
MBSS
Modified barium swallow
EMST
Expiratory muscle strength trainer
PMI
Personal meeting identification
VHI-10
Voice Handicap Index-10
RSI
Reflux symptom index
CSI
Cough severity index
DI
Dyspnea index
EAT-10
Eating assessment tool-10
TEP
Tracheoesophageal voice prosthesis
FEES
Flexible endoscopic evaluation of swallowing

Cited by (0)

Financial Support: None.

Conflicts of Interest: Clark A. Rosen reports the following disclosures and financial relationships: -Olympus America Inc.: Consultant-Instrumentarium: Royalties-Freundenberg Medical: Consultant-Reflux Gourmet LCC: ShareholderThe other authors have no financial relationships or conflicts of interest to disclose.

Meeting Poster/Presentation: N/A.

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