Tag Archive for: pandemic

How Will Telemedicine Continue to Evolve?

How Will Telemedicine Continue to Evolve? from Patient Empowerment Network on Vimeo.

How will the use of telemedicine continue to evolve? Watch as expert  Dr. Joseph Sirintrapun explains telemedicine benefits and expansion during the COViD-19 public health emergency and the potential for telemedicine evolution in the future.

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Lisa Hatfield:

Can you give a brief overview from your perspective, how telemedicine has evolved and continues to evolve and how you think it might evolve going forward? 

Dr. Sirintrapun:

Yeah, I think I like pulling out these old sayings and I think Winston Churchill was credited with it even though I don’t think he said it, but never let a good crisis go to waste. You probably heard that during COVID, and COVID really blew open the door for telemedicine. I think because we just had to, there was no choice behind that. And thankfully, people…organizations, people recognized it. And I remember in March, March 2020, the public health emergency was declared and a lot of different things that were barriers and a lot of them were regulatory. They were opened up so that it can enable reimbursements, all these different things that factor in. And being able to leverage the technologies, because keep in mind with providers, I knew providers that didn’t know how to use Zoom and other technologies. And because of COVID, they were forced, and they found out, “Hey, it’s not that bad.” But if I were to do that before the pandemic, they’d be like, “Well, why should I? We’ll just show up in this conference room. We’ll just be there at six o’clock in the morning.

So it opens people’s minds. And I think that really helped. I don’t think that Genie’s going back into the bottle, not at least completely. I think we’re going to figure different ways to leverage those technologies moving forward. So in terms of telemedicine moving forward, some of the things I’d like to see and hence I think this is maybe one of the reasons why I’m here, is like how do we enable clinical trials to embrace the telemedicine model? Because clinical trials till now historically has been kind of a physical model. You have to go to some ivory tower, some centralized place and that really limits down, the patients can do it. There’s access problems. Even if you had the richest study in the world, you had to fly people from all over the world. You can imagine that just drains the budget. There’s just all these different things there. And when you think of the way clinical trials are conducted, it didn’t really take into account telemedicine visits.

At my institution Memorial Sloan Kettering, we developed an entire ecosystem of telemedicine tools to actually try to encompass the patient experience as close as we could. Because the experience, it can never be completely duplicated, but you can do certain things definitely through telemedicine. We tried to do our best to do it so it’s easier for patients, the nurse coordinators as well as the providers to use that. And clinical trials, they’re moving towards it. They’re acknowledging the issue and they’re rethinking the ways to do it. How can we enable it so that we can decrease the chasm between the patient and being able to enroll in a clinical trial? So in a nutshell, that’s the way things are going. We’re not there yet, but we’re definitely thinking about it. It’s definitely a discussion. I think the future will see a much more clinically- and a telemedicine-enabled clinical trial framework.

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Lung Cancer Advocate Shares Importance of Staying Hopeful During Pandemic

Lung Cancer Advocate Shares Importance of Staying Hopeful During Pandemic from Patient Empowerment Network on Vimeo.

How can lung cancer patients stay hopeful during a pandemic? Watch as lung cancer patient Jill shares her advice on coping methods that have been helpful for her during the COVID-19 pandemic.

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These are really hard times, and we need to recognize that we’re not alone, that we’re not the only ones, we’re not the only one going through the hard time, and it’s so important to reach out to others, to reach out to someone, to ask for help, and we hear some really, really sad stories of things like people being turned away from the ER or we can have a lot of fear about what might happen. And I think it’s really important to not let those fears rule our lives, that can be really challenging to do, it’s very easy to say, but it takes a lot of skills to live without letting fear take hold at times. So, reach out for help. Talk to people, ask them, how do they cope? What do they do? For me, I talked to friends and my friends help remind me of what’s real and what’s true, my friends helped me hold on to hope. I’m a person of faith, so I believe in Jesus, and I read the Bible and I pray, and that really helps me too.

But each person finds their own ways to hold on to hope and let go of fear, and fear is, fear is not our friend. Good things don’t come from fear. So the other thing is we need to be advocates for ourselves, sometimes we need to ask for what we want, and if we believe in something, we need to fight for it, we can’t just sit back and expect things to be dropped in our lap, so they’re gonna be tons, when we’re going to have to really, really work hard, and that could hurt and in my life is an advocate, I find there’s a lot of pain and a lot of hard work, but there’s also a lot of real joy, and I get to meet some of the most amazing new people, and those are people who helped me have hope, so grab a hold of the people who help you have hope and don’t let go, call them up and reach out to them, lean on them.

What Multiple Myeloma Populations Will Benefit From Telemedicine?

What Multiple Myeloma Populations Will Benefit Most From Telemedicine? from Patient Empowerment Network on Vimeo

Which multiple myeloma patients will benefit most from telemedicine visits, and which patients can get more from in-person visits? Dr. Joseph Mikhael shares information on how to ensure the best myeloma care even during pandemic restrictions and how in-person visits have adjusted to limit COVID exposure risk.

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Dr. Joseph Mikhael:

When it comes to making a decision around, do I need to go into the clinic or can I do this as a telemedicine visit, of course, that has to be discussed with the healthcare team, but a few things we’ve learned through this pandemic.

And perhaps one of the most important things we’ve learned through the pandemic is that controlling one’s disease, controlling one’s myeloma is critical to protecting people against COVID, sadly, many of our patients who have struggled the most with COVID are those who had very active myeloma. So, we emphasize the importance of making sure that one continues to receive the best myeloma care possible, and very often that is going to involve an in-person visit, not only for discussion, but, of course, for the actual receiving of treatment. Secondly, I think it’s very important for us to note that we really have not seen significant spread of COVID or almost any infection within our hematology-oncology clinics, we’ve taken particular precaution around this area. So, this is different than someone maybe going out to a more public place where the risks may be higher. And so, we try to reassure our patients that coming into clinic actually is really not a high-risk situation and, in fact, perhaps lower risk than ever in light of the fact that many of our waiting areas and places where we have patients have been restructured and have fewer patients because of telemedicine visits.

And then thirdly, and very importantly, whether it’s telemedicine or in-person, it’s really important to maintain open, honest, and clear communication with the healthcare team. And if that is felt that it’s being done to a certain extent in telemedicine, fantastic, but there are situations where it’s challenging and difficult and really must be face-to-face. And so I would want to encourage my patients not to be afraid to go in to receive treatment and to meet with their healthcare team. These are generally very safe places that we take special precautions to ensure their patients can receive the best care possible.

What Are the Benefits of Telemedicine for Myeloma Patients?

What Are the Benefits of Telemedicine for Myeloma Patients? from Patient Empowerment Network on Vimeo

How will myeloma patients benefit from telehealth visits? Myeloma expert Dr. Sarah Holstein shares benefits she has seen while caring for her myeloma patients including broadening access and the ease of seeking a second opinion.

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Dr. Sarah Holstein

So, I think telemedicine has been one of the few silver linings of this entire pandemic, I had personally never utilized telemedicine previously in my career, and now I’m using it almost extensively these days to care for my myeloma patients.

I’ve always had patients who tell me that they wish they didn’t have to take a half day off to come to a clinic appointment, and sometimes the clinic appointments are only 20 minutes, but they’re driving an hour and a half or two hours or more to come to those clinic appointments. So, some of it has just been the freedom that allows patients to go about their lives and not have to take time off of work or time off from other things that they’re doing to physically travel to come and see me. Telemedicine though, has also really broadened the access to me in my cancer center, again, based on where I’m at in Nebraska, patients would sometimes have to travel a very far distance to see me, and these days it’s just a matter of logging on via Zoom to access me, and it’s allowed me to see patients for second opinions in not only different parts in Nebraska that otherwise would have been difficult to reach, but also really across the country.

So, telemedicine in general, has allowed patients much more flexibility in seeing me and has also allowed the ability for me to do second opinions without making patients travel quite a distance.

How Can Educators Adapt to Distance Learning During a Public Health Crisis?

Our education system is in a vulnerable state as we continue to battle COVID-19. Many questions are being asked in preparation for the upcoming school year. Is it too soon or even safe to reopen? Is virtual education best for students? There is also an underlying issue of preexisting disparities in education, such as the need for resources like basic learning tools. Educators must consider disparities that also extend into their student’s home life, such as lack of food and the responsibilities of caring for siblings because their parents have multiple jobs.

Teachers across the United States, including Virginia–my home state– are struggling with adapting to virtual teaching in addition to the challenges of preexisting disparities that affect the community of learning.  Loren and Nicole (names changed for discretion purposes), two Virginia educators express their views on the decisions made in their districts for reopening. They share with us their current challenges and their plan of action to prepare for an effective school year. This will require collective effort between teacher, parent, and student as they learn to adapt to the changing landscape of education in the age of the Coronavirus.

The VA District’s Decision

Public health is of the highest concern forcing policy makers to make many considerations regarding the pandemic and reopening of schools. Key federal government officials insist on schools reopening in fall despite the possibility of viral transmission.

Loren, a 24-year-old Special Education teacher stated, “Decisions for the reopening of the school have been heavily influenced by politics such as federal funding and the opinions from state governments on the reopening of school.” Nicole, an educator in mathematics of 39 years stated, “The governor has pretty much left it up to the schools to follow the guidelines that are outlined by the CDC and local health organizations as to whether we reopen schools or what not.”

When asked if educators in their Virginia school district were allowed input in the reopening, they both expressed there was some say in the decision making but ultimately the final decision was left to the school board. In Nicole’s district, surveys for reopening were distributed to parents and educators in June, July, and August to determine if in-person or virtual would be the best practice.  The final decisions were partly determined by the influx of COVID cases in their surrounding communities. The decision for both Nicole and Loren’s district settled on virtual learning.

As Loren and Nicole proceed in the virtual learning direction, their learning communities still have disparities to overcome. These existed pre-COVID era such as minimal resources and little to no experience with online education.

Underlying Conditions

In March, virtual learning was abruptly enforced on students and educators with little to no experience in this method. Prior to COVID, there has been an existing issue regarding the resources to execute work. This includes basic tools like pencils, textbooks, and internet connection. This extends outside of school needs and into the needs of the home as well.

Nicole says, “Thinking about my class, some kids had attendance issues. Some had issues with doing work although they came to school every day. So, lack of motivation for some students.”

Additionally, she brought attention to the challenges that exist in the home such as parental support. “Getting parents to attend conferences to discuss ways to help their child is already tough. So, you can only imagine how the situation will be during virtual.” For some students, outside responsibilities are priorities over their education like the need to tend to siblings in the home. Nicole also stated, “Some other issues were kids not having food or places to stay–shuffling from one family member to the next. Even cases of child neglect or abuse”. These issues take away from the child’s motivation which she noticed in their class participation.

In Loren’s case, parental support is also an issue for her students.  Her concern is if this will be any different virtually. Teaching students with learning disabilities requires a bit of extra attention. Since school will be completely virtual, these students will require the additional assistance from their parents and teachers.

The new direction of virtual education layered with inequitable conditions must be reflected upon. To ensure positive changes are made, educators, parents, and students will need to be equipped with the readiness tools for an effective and engaging school year. How will educators engage and empower students who will now be learning in an unfavorable environment? How can educators cultivate productivity throughout the day?

Tools for Readiness

We can’t move forward with virtual learning if our educators and students are unequipped with stable internet, virtual education training, and the basic tools needed to work.

Since there will be an increase in internet use in the home, the system needs to be stable to handle Zoom or the use of other online platforms. In March, Nicole’s school provided hotspots which were to be returned at the end of the school year. Pre-COVID each student was supplied with Chromebooks.

Virtual Education training is what will teach and empower educators and parents to be competent and successful in virtual learning strategies. Nicole mentioned that her school has been offering training on a learning management system called Canvas which merges assignments to be accessible from one location for easier use. Other outlets offer free resources for educators and students like webinars. Microsoft offers an online teaching guide to prepare educators from Pre-K to PhD with tools for online education. This is a full guide providing tips on making the virtual transition, maintaining engagement with students, and advice on enhancing the social experience for students and their families.

Creativity is needed to spark engagement. For many districts including Nicole and Loren’s, Zoom is being used to conduct the majority of classes. For educators that want a more hands on creative approach, they prefer the use of white boards or chalk boards. These can be mounted on the wall for use during the lesson or prerecorded then discussed during the session.

Creating a conducive work space is important for productivity and maintaining balance between work and life in the home. Educators, parents, and students can all benefit from tools that’ll empower them to minimize stress.

1. Pick the most quiet and productive area in the home for the school day.

  • Minimize distractions by only having the laptop in sight

2. Maintain an organized workspace.

  • Utilize binders and pencil pouches to keep the work area tidy.

3. Keep a bottle of water and a snack nearby.

  • Granola bars, trail mix, even fruit snacks are non-messy treats that’ll help keep you energized.

School districts are determining ways for families to receive resources like childcare and food. For students that need breakfast and lunch provided, Nicole’s district offers Meals-to-Go services at various locations for students to pick up. Parents can contact the school board to determine additional food options for their children. Nicole also stated that some schools may open to allow students that need supervision during the day. Unfortunately, many of Nicole’s students are considered lower income and face challenges that are only intensified by COVID restrictions.

As schools begin to reopen, we will uncover more concerns sparked by the virus. We will continue to learn how to overcome existing disparities among students and educators, and determine if virtual education training and suggested tools are benefiting educators. For vulnerable populations, COVID has only exacerbated existing issues making it more difficult to get through virtual learning. We cannot ignore these issues and hope for students’ success virtually. This change is a collective effort from school boards, educators, parents, and the entire community. We will power through this challenging time of learning to adapt to life during the pandemic that continues to reshape our education system.