Yıl: 2022 Cilt: 85 Sayı: 1 Sayfa Aralığı: 9 - 14 Metin Dili: İngilizce DOI: 10.26650/IUITFD.932128 İndeks Tarihi: 27-08-2022

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

Öz:
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 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.
Anahtar Kelime:

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

Öz:
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 dakika olarak saptanmıştır (<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.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 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]
APA Ören M, Özgülnar N, Canbaz S, KARABEY S, Önal A, Oncul O (2022). AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. , 9 - 14. 10.26650/IUITFD.932128
Chicago Ören Merve,Özgülnar Nuray,Canbaz Sevgi,KARABEY SELMA,Önal Ayşe Emel,Oncul Oral AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. (2022): 9 - 14. 10.26650/IUITFD.932128
MLA Ören Merve,Özgülnar Nuray,Canbaz Sevgi,KARABEY SELMA,Önal Ayşe Emel,Oncul Oral AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. , 2022, ss.9 - 14. 10.26650/IUITFD.932128
AMA Ören M,Özgülnar N,Canbaz S,KARABEY S,Önal A,Oncul O AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. . 2022; 9 - 14. 10.26650/IUITFD.932128
Vancouver Ören M,Özgülnar N,Canbaz S,KARABEY S,Önal A,Oncul O AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. . 2022; 9 - 14. 10.26650/IUITFD.932128
IEEE Ören M,Özgülnar N,Canbaz S,KARABEY S,Önal A,Oncul O "AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH." , ss.9 - 14, 2022. 10.26650/IUITFD.932128
ISNAD Ören, Merve vd. "AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH". (2022), 9-14. https://doi.org/10.26650/IUITFD.932128
APA Ören M, Özgülnar N, Canbaz S, KARABEY S, Önal A, Oncul O (2022). AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. İstanbul Tıp Fakültesi Dergisi, 85(1), 9 - 14. 10.26650/IUITFD.932128
Chicago Ören Merve,Özgülnar Nuray,Canbaz Sevgi,KARABEY SELMA,Önal Ayşe Emel,Oncul Oral AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. İstanbul Tıp Fakültesi Dergisi 85, no.1 (2022): 9 - 14. 10.26650/IUITFD.932128
MLA Ören Merve,Özgülnar Nuray,Canbaz Sevgi,KARABEY SELMA,Önal Ayşe Emel,Oncul Oral AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. İstanbul Tıp Fakültesi Dergisi, vol.85, no.1, 2022, ss.9 - 14. 10.26650/IUITFD.932128
AMA Ören M,Özgülnar N,Canbaz S,KARABEY S,Önal A,Oncul O AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. İstanbul Tıp Fakültesi Dergisi. 2022; 85(1): 9 - 14. 10.26650/IUITFD.932128
Vancouver Ören M,Özgülnar N,Canbaz S,KARABEY S,Önal A,Oncul O AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH. İstanbul Tıp Fakültesi Dergisi. 2022; 85(1): 9 - 14. 10.26650/IUITFD.932128
IEEE Ören M,Özgülnar N,Canbaz S,KARABEY S,Önal A,Oncul O "AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH." İstanbul Tıp Fakültesi Dergisi, 85, ss.9 - 14, 2022. 10.26650/IUITFD.932128
ISNAD Ören, Merve vd. "AN INTEGRATED CARE MODEL BASED ON HOSPITAL AND HOME DURING THE COVID-19 PANDEMIC: TELEHEALTH". İstanbul Tıp Fakültesi Dergisi 85/1 (2022), 9-14. https://doi.org/10.26650/IUITFD.932128