Journal of Urology and Renal Diseases (ISSN: 2575-7903)

editorial

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The Application of Telemedicine in Urology

Authors: Usama Nihad Rifat*

*Corresponding Author: Usama Nihad Rifat, Emeritus Professor of Urology, Iraqi Board for Medical Specializations, 954410, Amman, Jordan

Emeritus Professor of Urology, Iraqi Board for Medical Specializations, Amman, Jordan

Received Date: 16 March, 2022

Accepted Date: 17 March, 2022

Published Date: 21 March 2022

Citation: Rifat UN (2022) The Application of Telemedicine in Urology. J Urol Ren Dis 07: 1255. DOI: https://doi.org/10.29011/2575-7903.001255

Editorial

Traditionally, telehealth was not widely used in Urology, but Urologists' usage of telemedicine nearly tripled during the Covid 19 pandemic. It was successful for managing some common urological conditions, including erectile dysfunction, infertilityuncomplicated urinary stones, uncomplicated urinary infections, and urinary incontinence. While the rates of telehealth adoption may decrease slightly from pandemic levels, virtual visits are likely to play a larger role in urology in the future [1]. There are differences in the use of telemedicine. These differences were not associated with provider qualities. Further study is needed to overcome barriers in access to telemedicine. Telemedicine can be successfully integrated into urologic practices but there are disparities in utilization based on patient age, race/ethnicity, and insurance status. Urologic community attention is necessary to promote equal access to telemedicine modalities as this technology will continue to be an integral role in future practice [2].

The spread of coronavirus disease 2019 (COVID-19) infections has recently increased the interest in telehealth, which is the approval of telecommunication to deliver any health care activity. The available literature indicates that telemedicine has been adopted successfully in selected patients with several common clinical urological conditions, including prostate cancer, uncomplicated urinary stones, uncomplicated urinary infections, urinary incontinence, or pelvic organ prolapse. The COVID-19 pandemic will give a significant boost to the use of telemedicine, but more data on long-term efficacy, safety, and costs are necessary [3]. Telehealth is watchfully used in urology. Barriers to accomplishment include technological skill, repayment uncertainties, and resistance to change in workflow. Telehealth technologies are shown to be safe, effective, and satisfactory for patients and providers. Further investigation is necessary to determine the efficacy of telehealth applications [4]. The COVID-19 pandemic has transformed healthcare delivery by introducing telehealth into common practice. Through telehealth-integrated patient management protocols and payment reforms, telehealth can have a constant effect on urological care delivery even after the pandemic. Urologists should take this opportunity to shift the way we deliver care for many common urological diagnoses.

The Telehealth modalities could be:

  1. Video visit, which is a live simultaneous audiovisual visit between patient and provider using teleconferencing software.
  2. Virtual check-in is a brief visit between patient and provider using telephone or teleconferencing software to determine whether in-person evaluation is needed.
  3. eVisit is a communication between patient and provider via an online patient portal.
  4. eConsult (interprofessional consult) A written electronic communication between referring provider and consulting physician involving review of a patient’s medical record and treatment recommendations [5].

Urology providers are generally satisfied with their experience communicating with patients via

telemedicine and the majority would decide on to continue utilizing telemedicine. Nevertheless, many providers are hesitant to schedule surgery via telemedicine [6].

Telehealth was utilized for a wide range of diseases and often used in conjunction with primary care (PC) and urologic Face-to-Face (FTF) visits to deliver complete care. The most common urologic conditions evaluated during the initial telehealth meeting (including both general urology and sexual dysfunction clinics) were sexual dysfunction 26.8% (217/811), LUTS 20.6% (167/811), hematuria 15.0% (122/811), prostate cancer 13.3% (108/811), and an elevated PSA 12.1% (98/811) [7]. Urology Virtual clinics are a promising new platform which can offer clinical, financial and environmental benefits to support an increasing urological referral burden. Further prospective evidence is required across urological sub-specialties to confirm equivalency and safety against traditional face to face assessment [8]. Telemedicine approach limits the number of unnecessary accesses to medical facilities and represents an important tool for the limitation of the risk of transmission of infectious diseases, such as COVID-19. However, infrastructures, health workers, and patients should reach out to a computerization process to allow a wider diffusion of more advanced forms of telemedicine, such as televisit [9].

Another study indicated that telemedicine could achieve a cost savings without compromising the safety or adversely affecting patient management. Further studies should define the benefits and any limitations, and reveal how the technology could be used effectively [10]. In the field of children with neurogenic bladder, telehealth as a community-monitoring project within children’s urology care is an innovative development. There is limited evidence of the inclusion of staff and parents in the early-stage development and later adoption of telehealth initiatives within routine urological nursing care or families’ management of their child’s bladder. The aim was to explore the experiences of involved individuals (parents, clinicians, and technical experts) in terms of remote community-based urinalysis monitoring by parents of their child’s urine. Methods designed used soft systems methodology tools to inform data collection and analysis following interviews, observation, and e-surveys. Other findings showed that the parents adopted aspects of the telehealth intervention (urinalysis) but were less engaged with the voiding diary and weighing. The parents gained confidence in decision-making and identified that the intervention reduced delays in their child receiving appropriate treatment, decreased the time burden, and improved engagement with general practitioners. Managing the additional workload was a challenge for the clinical team. Parental self-efficacy was a clear outcome from the intervention. Parents exercised their confidence and control and were selective about which aspects of the intervention they observed as having credibility and which they valued [11].

Telemedicine adoption increased in rural and remote areas during the COVID-19 pandemic, but its use increased in urban and less rural populations. Future studies should investigate the potential barriers to telemedicine use among rural patients and the impact of rural telemedicine on patient health care utilization and outcomes [12]. To conclude I quote from the American Urological Association task force report that was revised last year. The report declares that Urology telemedicine has developed in many different formats and serves as examples of how an electronic revolution like Gutenberg’s printing press has the potential to transform health care. Telemedicine may help address the anticipated shortage of urologists in the near future. It is crucial to focus on those who benefit most from this new technology (i.e. underserved populations) and ensure equal access. Urologists have been pioneers in the use of telemedicine, particularly in the areas of telerobotic surgery, teleproctoring, telementoring, and telerounding. It is possible that telemedicine will become completely integrated into urologic training and health care delivery to fulfill the proposition of access and quality of urologic care [13].

References

  1. Avery Morrison (2021) Advisory Board, Increasing telehealth adoption 2021.
  2. Juan Javier-DesLoges, Margaret Meagher, Shady Soliman, Julia Yuan, Kevin Hakimi, et al. (2021) Disparities in Telemedicine Utilization for Urology Patients During the COVID-19 Pandemic UROLOGY 2021: 1-5.
  3. Giacomo Novara, Enrico Checcucci, Alessandro Crestani, Alberto Abrate (2020) Telehealth in Urology: A Systematic Review of the Literature. How Much Can Telemedicine Be Useful During and After the COVID-19 Pandemic? European Association of Urology 78: 786-811.
  4. Peris Castaneda, Chad Ellimootti (2020) Current use of telehealth in urology: a review. World Journal of Urology 38: 2377-2384
  5. Adam J. Gadzinski, Chad Ellimoottil (2020) Telehealth in urology after the COVID-19 pandemic. NAture Reviews | Urology 17: 363-364.
  6. Jessica Connor, Yu Zheng, Katherine Houle, Lindsey Cox (2021) Adopting Telehealth During The COVID-19 Era: The Urologist’s Perspective. UROLOGY 156: 289-295.
  7. Alex Nourian, Nicholas Smith, Leonard Kleinman, Richard Boxer (2021) A 5-Year Single-Institution Experience Integrating Telehealth Into Urologic Care Delivery. TELEMEDICINE and e-HEALTH 27: 997-1002.
  8. Marie Alexandra Edison, Martin John Connor, Saiful Miah, Tamer El-Husseiny (2020) Understanding virtual urology clinics: a systematic (review). BJU Int 126: 536-546.
  9. Enrico Checcucci, Stefano De Luca, Paolo Alessio, Paolo Verri (2021) Implementing telemedicine for the management of benign urologic conditions: a single centre experience in Italy. World Journal of Urology 39: 3109-3115.
  10. Santiago Vallasciani, Badawiya Abdo, Zainab Rauf, Abeeda Anjum (2018) Telehealth for the Assessment of Patients Referred for Pediatric Urological Care: A Preliminary Cost Savings Analysis and Satisfaction Survey. TELEMEDICINE and e-HEALTH , MARY ANN LIEBERT, INC 25: 756-761.
  11. Bernie Carter, Karen Whittaker, Caroline Sanders (2019) Evaluating a telehealth intervention for urinalysis monitoring in children with neurogenic bladder. Journal of Child Health Care 23: 45-62.
  12. Cherry Chu, Peter Cram, Andrea Pang, Vess Stamenova1 (2021) Rural Telemedicine Use Before and During the COVID-19 Pandemic: Repeated Cross-sectional Study. J Med Internet Res 23: 26960.
  13. Matthew Gettman, Eric Kirshenbaum, Eugene Rhee, Aaron Spitz (2021) Telemedicine in Urology 2021.

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