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      Teleconsultation for outpatient care of patients during the Covid-19 pandemic at a University Hospital in Colombia

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          Abstract

          Background

          During the COVID 19 pandemic, direct-to-consumer telehealth (DTC) services allowed patients real-time virtual access to healthcare providers, especially those with an established relationship. In Colombia, this care modality was implemented between 2019 and 2020, under national considerations, it was implemented for outpatient care in a highly complex university hospital in Cali, Colombia.

          Methods

           A descriptive study with prospective information collection was used to describe the implementation of the outpatient teleconsultation care model for patients. We constructed the clinical and process indicators with which we evaluated the model.

          Findings

          A total of 56,560 patients from our institution were treated by virtual outpatient consultation during the first nine months of the health emergency declared by COVID 19 in Colombia. The strategy made it possible to achieve coverage more significant than 100% in Cali and the departments of Colombia. Attention by teleconsultation was 19% of the total ambulatory care. The effectiveness in carrying out scheduled teleconsultations had an overall result of 91.5%. The accessibility results demonstrated the need to strengthen connectivity and accessibility to payments and strengthen technology adoption in the institution, health personnel, and patients.

          Interpretation

          Implementing an outpatient teleconsultation model allowed the continuity of the management with comprehensive coverage nationwide from a highly complex hospital in southwestern Colombia. The indicators' analysis should help strengthen the policies of access to telemedicine, especially with the consequences of the pandemic in low- and middle-income countries. Latin American evidence is necessary to establish the safety profile of telemedicine and the costs associated with the provision.

          Funding

          No fundings to report.

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          Most cited references8

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          Telemedicine and the COVID-19 Pandemic, Lessons for the Future

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            Telehealth.

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              Telemedicine Pays: Billing and Coding Update

              Purpose of Review Telemedicine is a rapidly growing healthcare sector that can improve access to care for underserved populations and offer flexibility and convenience to patients and clinicians alike. However, uncertainty about insurance coverage and reimbursement policies for telemedicine has historically been a major barrier to adoption, especially among physicians in private practice (the majority of practicing allergists). Recent Findings The COVID-19 public health emergency has highlighted the importance of telehealth as a safe and effective healthcare delivery model, with governments and payers rapidly expanding coverage and payment in an effort to ensure public access to healthcare in the midst of an infectious pandemic. This comprehensive review of updated telemedicine coverage and payment policies will include a tabular guide on how to appropriately bill and optimize reimbursement for telemedicine services. Summary This review of current trends in telemedicine coverage, billing, and reimbursement will outline the historical and current state of telemedicine payment policies in the USA, with special focus on recent policy changes implemented in light of COVID-19. The authors will also explore the potential future landscape of telehealth coverage and reimbursement beyond the resolution of the public health emergency.
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                Author and article information

                Journal
                Int J Med Inform
                Int J Med Inform
                International Journal of Medical Informatics
                Elsevier B.V.
                1386-5056
                1872-8243
                21 September 2021
                21 September 2021
                : 104589
                Affiliations
                [a ]Department of Obstetrics and Gynecology, School of Medicine, Universidad Icesi, Cali, Colombia
                [b ]Department of Telemedicine, Fundación Valle del Lili, Cali, Colombia
                [c ]Department of Information technology, Fundación Valle del Lili, Cali, Colombia
                [d ]Department of Outpatient Medical Care, Fundación Valle del Lili, Cali, Colombia
                [e ]Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
                Author notes
                [* ]Corresponding author
                Article
                S1386-5056(21)00215-X 104589
                10.1016/j.ijmedinf.2021.104589
                8453779
                34592540
                c9371f0f-343a-4103-bdc1-41a556663d0b
                © 2021 Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 11 August 2021
                : 15 September 2021
                : 19 September 2021
                Categories
                Article

                ehealth,telemedicine,tele consultation,indicators
                ehealth, telemedicine, tele consultation, indicators

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