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      Telepresence Robots at the Urology and Emergency Department: A Pilot Study Assessing Patients' and Healthcare Workers' Satisfaction

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          Abstract

          COVID-19 intensified interest in telemedicine, yet no study has evaluated the use of a telepresence robot on unselected urological patients. Therefore, we performed a survey study of patients, bedside caregivers and urologists, investigating the satisfaction and applicability of a telepresence robot (Beam Pro, Suitable Technologies, USA) at the urology ward and emergency department. The primary outcome was the number of patient encounters solved without the urologist's physical presence. Between March 2021 and May 2021, patients, caregivers, and urologists filled in 42, 35, and 54 questionnaires, respectively. Most patients were male (79%), with a mean age of 64 (SD ± 17). Two of the department's ten urologists participated. The urologists responded that physical examination was required in 7 (13%) encounters. The caregivers would have preferred the urologist physically present in 11 (31%) cases. Most patients (71%) “agreed” or “strongly agreed” that they were willing to be attended by a telepresence robot at future evaluations and generally, patients gave high satisfaction scores. Though implementation among the department's urologists was a major challenge, participating urologists reported that physical presence could be avoided in 87% of the patient encounters. Studies of patient-reported outcome measures comparing telemedical and physical patient encounters are needed.

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          Efficiency, satisfaction, and costs for remote video visits following radical prostatectomy: a randomized controlled trial.

          Telemedicine in an ambulatory surgical population remains incompletely evaluated.
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            Telehealth in Urology: A Systematic Review of the Literature. How Much Can Telemedicine Be Useful During and After the COVID-19 Pandemic?

            Context Coronavirus disease 2019 (COVID-19) pandemic has caused increased interest in the application of telehealth to provide care without exposing patients and physicians to the risk of contagion. The urological literature on the topic is sparse. Objective To perform a systematic review of the literature and evaluate all the available studies on urological applications of telehealth. Evidence acquisition After registration on PROSPERO, we searched PubMed and Scopus databases to collect any kind of studies evaluating any telehealth interventions in any urological conditions. The National Toxicology Program/Office of Health Assessment and Translation Risk of Bias Rating Tool for Human and Animal Studies was used to estimate the risk of bias. A narrative synthesis was performed. Evidence synthesis We identified 45 studies (11 concerning prostate cancer [PCa], three hematuria management, six urinary stones, 14 urinary incontinence [UI], five urinary tract infections [UTIs], and six other conditions), including 12 randomized controlled trials. The available literature indicates that telemedicine has been implemented successfully in several common clinical scenarios, including the decision-making process following a diagnosis of nonmetastatic PCa, follow-up care of patients with localized PCa after curative treatments, initial diagnosis of hematuria, management diagnosis and follow-up care of uncomplicated urinary stones and uncomplicated UTIs, and initial evaluation, behavioral therapies, and pelvic floor muscle training in UI patients, as well as follow-up care after surgical treatments of stress urinary incontinence or pelvic organ prolapse. The methodological quality of most of the reports was good. Conclusions Telehealth has been implemented successfully in selected patients with PCa, UI, pelvic organ prolapse, uncomplicated urinary stones, and UTIs. Many urological conditions are suitable for telehealth, but more studies are needed on other highly prevalent urological malignant and benign conditions. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine. More robust data on long-term efficacy, safety, and health economics are necessary. Patient summary The diffusion of coronavirus disease 2019 (COVID-19) infections has recently increased the interest in telehealth, which is the adoption 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. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine, but more robust data on long-term efficacy, safety, and costs are necessary.
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              Telemedicine and Smart Working: Recommendations of the European Association of Urology

              Context Telemedicine provides remote clinical support using technological tools. It may facilitate health care delivery while reducing unnecessary visits to the clinic. The coronavirus disease 2019 (COVID-19) outbreak has caused an abrupt change in our daily urological practice, converting many of us to be reliant on telehealth. Objective To provide practical recommendations for effective use of technological tools in telemedicine. Evidence acquisition A Medline-based and gray literature search was conducted through April 2020. We selected the most relevant articles related to “telemedicine” and “smart working” that could provide important information. Evidence synthesis Telemedicine refers to the use of electronic information and telecommunications tools to provide remote clinical health care support. Smart working is a model of work that uses new or existing technologies to improve performance. Telemedicine is becoming a useful invaluable tool during and even beyond the COVID-19 pandemic. It is time for us to formalize the place of telemedicine in routine urological practice, and it is our responsibility to adapt and learn about all the tools and possible strategies for their optimal implementation during the pandemic to ensure that the quality of care received by patients and the outcomes of patients and their families are of the highest standard. Conclusions Telemedicine facilitates specialized urological clinical support at a distance, solves problems of limitations in mobility, reduces unnecessary visits to clinics, and is useful for reducing the risk of viral transmission in the current COVID-19 outbreak. Furthermore, both personal and societal considerations may favor continued use of telemedicine, even beyond the COVID-19 pandemic. Patient summary Telemedicine in urology offers specialized remote clinical support to patients, similar to face-to-face visits. It is very useful for reducing unnecessary visits to the clinic, as well as reducing the risk of contagion in the current coronavirus disease 2019 (COVID-19) pandemic.
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                Author and article information

                Contributors
                Journal
                Int J Telemed Appl
                Int J Telemed Appl
                ijta
                International Journal of Telemedicine and Applications
                Hindawi
                1687-6415
                1687-6423
                2022
                15 March 2022
                : 2022
                : 8787882
                Affiliations
                1Department of Urology, Hospital of Southern Jutland, 6200 Aabenraa, Denmark
                2The Learning and Research Department, Hospital of Southern Jutland, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark
                Author notes

                Academic Editor: Fei Hu

                Author information
                https://orcid.org/0000-0001-5297-3769
                https://orcid.org/0000-0002-8146-6501
                https://orcid.org/0000-0001-5349-1585
                Article
                10.1155/2022/8787882
                8941569
                d4fa9d94-575f-4417-8bc3-86c491e7760d
                Copyright © 2022 Jens Laigaard et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 3 August 2021
                : 18 February 2022
                : 7 March 2022
                Categories
                Research Article

                Medicine
                Medicine

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