J Korean Neurosurg Soc.  2023 Sep;66(5):573-581. 10.3340/jkns.2022.0211.

The Direction of Neurosurgery to Overcome the Living with COVID-19 Era : The Possibility of Telemedicine in Neurosurgery

• Lee MH
• Jang SR
• Lee TK

• KMID: 2545348
• DOI: http://doi.org/10.3340/jkns.2022.0211

Abstract

Objective
: Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited.
Methods
: The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire.
Results
: During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor’s explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time.
Conclusion
: In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.

Keyword

Neurosurgery; COVID-19; Telemedicine; Outpatients; Intensive care units

Figure

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  Fig. 1. Demonstration of a video patient meeting in the neurosurgical intensive care unit (ICU) A : Patient and caregiver talking to each other through the screen. B : Explaining the patient’s condition to the caregiver.

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  Fig. 2. Association between coronavirus disease 2019 (COVID-19) outbreak and head trauma patients in 2021. A : Weekly number of COVID-19 patients (blue bar) and proportion of the population who received a second dose of COVID-19 vaccination (red line) in northern Gyeonggi Province. B : Weekly number of head trauma patients in 2021. C : Proportion of major trauma and mortality cases in head trauma patients. D : Comparison of head trauma incidence in patients involved in traffic-related accidents (blue bar) and non-traffic-related accidents (red bar). TA : traffic accidents.

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  Fig. 3. Association between coronavirus disease 2019 (COVID-19) outbreak and stroke patients in 2021. A : Weekly number of COVID-19 patients (blue bar) and proportion of the population who received a second dose of COVID-19 vaccination (red line) in northern Gyeonggi Province. B : Weekly number of stroke patients in 2021. C : Proportion of major stroke and mortality cases in stroke patients. D : Comparison of hemorrhagic stroke (blue bar) and ischemic stroke (red bar) in stroke patients.

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  Fig. 4. The questionnaire and its results.

Reference

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