picot question for telehealth

%PDF-1.7 % Columbia, MD, Bryan Gale, MA Cbc can be offered to video conferencing and a nominee aspect utilize the increased help-seeking behavior for ethnic . The increased use of telehealth during the COVID-19 pandemic has not been without challenges. These types of guidance documents help to ensure that patients are receiving telehealth and in-person care in a consistent way, that the capabilities and limitations of telehealth are communicated effectively, and can ease the adjustment for providers with minimal prior experience performing telehealth. 91 42 endobj Centers for Medicare & Medicaid Services. 7. (C) Comparison or alternative intervention, or issue of interest. The PICOT process begins with a case scenario, and the question is phrased to elicit an answer. Telehealth can assist healthcare systems, organizations, and providers in expanding access to and improve the quality of rural healthcare. Accessed April 26, 2020. please use the PICOT question examples In addressing these barriers and associated issues, it is also clear that safeguards are required to protect patients and ensure that the standard defining quality care provisions are upheld. As a master's prepared nurse in an advanced practice role, discuss how you would evaluate the quality and effectiveness of a telehealth tool. <>/MediaBox[0 0 612 792]/Parent 9 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/StructParents 0/Tabs/S/Type/Page>> https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Multilayered%20Analysis%20of%20Telehealth%20-%20A%20FAIR%20Health%20White%20Paper.pdf. below and then select the answers that best fit your statistical objective. This allows patients to receive care from the safety of their homes and avoid exposure to the virus during transit or at in-person appointments. Rapidly accelerating telehealth capabilities may be necessary for many institutions as the healthcare community tackles the COVID-19 epidemic. (Time is optional). Us, Quick-Start Guide to Telehealth During a Crisis, COVID-19 Telehealth Resources - Building a Telehealth Program, Telehealth and Telemedicine Publications and Resources, https://www.fcc.gov/general/telehealth-telemedicine-and-telecare-whats-what, https://www.ahip.org/wp-content/uploads/IB_Telehealth-031219.pdf, https://www.healthaffairs.org/do/10.1377/hblog20200315.319008/full/, https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Multilayered%20Analysis%20of%20Telehealth%20-%20A%20FAIR%20Health%20White%20Paper.pdf, http://www.medpac.gov/docs/default-source/reports/mar18_medpac_ch16_sec.pdf?sfvrsn=0, https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak, https://www.cms.gov/newsroom/press-releases/trump-administration-makes-sweeping-regulatory-changes-help-us-healthcare-system-address-covid-19, https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf, https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19, The Role of Telehealth in the COVID-19 Crisis, In Conversation With Joel Willis, DO, PA, MA, MPhiL and Neal Sikka, MD. endobj 6 0 obj Using the PICOTS Framework to Strengthen Evidence Gathered in Clinical TrialsGuidance from the AHRQ's Evidence-based Practice Centers Program Appropriate for: clinical questions, often addressing the effect of an intervention/therapy/treatment. In the text box below, enter text describing the intervention that is being administered and click on the Submit button. T- Time period(ie. A systematic review and meta-analysis. In _______ (P), how does ________ (I) compared to ________ (C) influence _________ (O) over _________ (T)? stream endobj As providers and patients become more familiar with the technical aspects of telehealth, and as patients understanding of both the benefits and limitations of telehealth increases, telehealth will become a part of standard practice for delivering safe, high-quality healthcare. Is the presentation clear and easy to follow? Health Affairs Blog. Fu, View answer & additonal benefits from the subscription, Explore recently answered questions from the same subject, Explore documents and answered questions from similar courses. The statistical test used to answer your PICOT question. Over the past decade, private insurers have greatly expanded telehealth coverage, recognizing its ability to provide affordable expanded access and care for patients. Remember that this must be in relation to selected patient population above. MEDPAC. Telehealth can be an effective way of limiting patient exposure to individuals who have- or may have- contracted the virus that causes COVID-19. %PDF-1.3 % All references and sources must meet the latest style of APA 6th edition. 0000003138 00000 n uuid:0d82ba50-b276-11b2-0a00-9093c99cfe7f PICOT Worksheet. Accessed May 6, 2020. In _________ (P), how does _________ (I) compared to _________(C) affect _______(O) within _______ (T)? <> This model helps us create searchable clinical questions before we start looking at the literature. What time periods should be considered? In 2016, telehealth accounted for $27 million in Medicare spending under the physician fee schedule (PFS). Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation. First, providers need to understand the limitations of delivering care remotely and the implications on their diagnostic capabilities, particularly among providers who have limited prior telehealth experience. Question: Is ddimer assay more accurate at ruling out deep vein thrombosis compared to ultrasound? This has included several provisions related to the use of telehealth, including the expansion of what services may be provided virtually.8Private insurers are also taking steps to support the use of telehealth, such as expanding lists of eligible services, waiving cost sharing, and providing monitoring devices to patients.9 Through necessity and as a result of these emergency provisions, the use of telehealth technologies, and broader application of telehealth concepts outside of CMS technical standards, has rapidly increased. Secondary Research Articles ; 0000045284 00000 n In_________________(P), how does_________________(I) compared to_________________ (C) influence_________________(O)? Adapted from: Melnyk, B. M., & Fineout-Overholt, E. (2011). Her rheumatologist suggested she start on Plaquenil for her joint pain, but she is interested in alternative therapies because she heard about success a neighbor had with turmeric tea. 0000003992 00000 n endobj <]>> xY}W,]- lA~Twp9$WwA/=u=u_ano?jy?~C&1l8TiOx:R){So_I|6=nhxAHL2Ax`[=, Patient Satisfaction with Telehealth Services Compared to In-Office Visits: A Systematic Literature Review. uuid:0d82ba4f-b276-11b2-0a00-90a288020000 It can be helpful to classify your question based on the clinical domain (s) it falls under. 8 0 obj From COVID-19 pandemic to patient safety: a new "spring" for telemedicine or a boomerang effect? See below for definitions, PICO templates, and example questions from the primary clinical domains: intervention, diagnosis, etiology, prevention, prognosis/prediction, quality of life/meaning, and therapy. Your patient and her wife have lived together for 10 years, and while she doesn't smoke, her partner does. Scenario: Your female patient is concerned about her risk of developing breast cancer. I have taught the PICOT <>/Metadata 2 0 R/Outlines 5 0 R/Pages 3 0 R/StructTreeRoot 6 0 R/Type/Catalog/ViewerPreferences<>>> endobj Claude Moore Health Sciences Library PICO is a useful framework for clinical research questions, but may not be appropriate for all kinds of reviews. 39 0 obj This worksheet will help you build a PICOT question and identify keywords for your searchable question. (O) Outcome (s) of interest. <> In addition to the more traditional uses of telehealth, the COVID-19 crisis has necessitated creative thinking about how telehealth technology can help protect providers. Pubmed Clinical Queries. "Over six month period.." or "In three years"). The elements include (P) which represents population, patient or problem, (I) which represents intervention or indicator, (C) which stands for comparison, (O) which represents outcome, and (T) which stands for time of study. What is the management strategy, diagnostic test, or exposure that you are interested in? P- female non smokers w/ daily second hand smoke exposure, C- female non smokers w/o daily smoke exposure. A PICOT question should be specific to make it researchable. P refers to the population/ Patient or the problem. This article uses the Systems Engineering Initiative for Patient Safety (SEIPS) model to assess barriers related to telehealth implementation during the pandemic and the impact on patients, providers, technology, care processes, organizations, and the environment. Use and impact of virtual primary care on quality and safety: The public's perspectives during the COVID-19 pandemic. https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak. Is a PKU test (I) done on two week old infants (P) more accurate in diagnosis inborn errors in metabolism (O) compared with PKU tests done at 24 hours of age (C)? You will be prompted below to choose one of four potential statistical objectives for 32 0 obj Please remember to use EBP assessment tools. 5 0 obj <>11]/P 19 0 R/Pg 196 0 R/S/Link>> 0000045635 00000 n %PDF-1.5 Telehealth is a recent concept in hypertension management, and involves using electronic technology to monitor patients' vital signs, such as blood pressure, in their homes. <>21]/P 27 0 R/Pg 45 0 R/S/Link>> It may include clinical care services, education for both patients and providers, and public health or healthcare administrative services. Identifying barriers to and opportunities for telehealth implementation amidst the COVID-19 pandemic by using a human factors approach: a leap into the future of health care delivery? AHIP. 0000006006 00000 n xKo8x^@Q qbdSXIT+e%EruG#/:LjlNgx{oH,>~$Wr9;?22{?\xD"g>y>}w8?x5WeqMQ2LL]\4)uf(vx;^O"+O=_(XzAD"o~7qG|K&0 H8Y_wkT9\:W Chief, Innovative Practice and Telehealth Section, Department of Emergency Medicine Example: For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations(C)improve blood sugar control(O)? The evidence to support the role of telehealth is strong. Construct your PICOT question in the standard PICOT question format (narrative) and define each letter separately, such as: o P = Native American Diabetic Communities in NM o I = Use Tele-med for monthly follow-up care o C = In comparison to 6 month MD office visits o O = To reduce hospitalizations caused by diabetic complications o T = Over the What are the patient-relevant consequences of the intervention? Clinical reasoning in dire times- analysis of cognitive biases in clinical cases during the COVID-19 pandemic. R%S~E8EC tns;H]$-MhZ9\54sgK%!#fjYbj0>7tyTB4,A|:m;]CE+k +ikxF39hi:R*56jKI. How do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)? Scenario: You have a femalepatient who has recently been diagnosed with SLE. <>33 0 R]/P 6 0 R/S/Link>> Federal Communications Commission. What is the outcome that may be affected by the exposure (dependent variable)? What kinds of interventions would fall under the umbrella of 'telehealth'? Eight research . Running head: EBP TELEHEALTH Evidence Based Practice: Use of Telehealth to Reduce Rehospitalizations in the CHF Population Chadwick Boberg, RN, BSN . endobj For patients 65 years and older (P), how does the use of an influenza vaccine (I) compared to not received the vaccine (C) influence the risk of developing pneumonia (O) during flu season (T)? With this unprecedented surge in use of telehealth, there is matter of delivering quality care. And if you do choose to submit as a logged-in user, your name will not be publicly associated with the case. endobj 0000002155 00000 n 72.6% of patients have income at or below 100% of the federal poverty level. What action is taken for the users, potential users, or stakeholders? withtheleadinvestigators.Thisformatenabled usto question theinvestigatorsaboutcore projectdesignelements,keychallenges, lessonslearned, andfuturedirections.Thestoriesof theseprojectsarepresentedbelow. In middle-aged men with suspected myocardial infarction (P), are serial 12-lead ECGs (I) compared with one initial 12-lead ECG (C) more accurate in diagnosing an acute myocardial infarction (O)? Evidence of respiratory infection transmission within physician offices could inform outpatient infection control. 3 0 obj <>15]/P 20 0 R/Pg 196 0 R/S/Link>> Washington, DC, Kendall K. Hall, MD, MS interventions, prevention, prognosis, diagnosis, or etiology, AppendPDF Pro 6.3 Linux 64 bit Aug 30 2019 Library 15.0.4 Patient safety in dermatology: a ten-year update. 62 0 obj 0000031290 00000 n Published March 30, 2020. Nevertheless, examination of this technology indicates that while there is a great deal of potential, implementing telemedicine also encompasses many barriers. endobj A qualitative study of interprofessional dissonance in hospital infection prevention and control. Keeping patients on track with preventative care during pandemic. xWN@}z}-I$RS_:\U Fwv=38{e5Q;;^U%i:+'.7NHd2jVpy[Qrw_$$p5$isng?vo!'q, Utilizing Telehealth Technology to Reduce Social Isolation and Depression in Seniors. endobj The last element is optional. dimer assay more accurate at ruling out deep vein thrombosis compared to ultrasound? Columbia, MD. %PDF-1.7 % 5-8. Who is the group of people being studied? If implemented appropriately, telehealth can be an incredibly effective approach to ensuring patient and provider safety during this unprecedented outbreak. How has the research been collected (e.g., interview, survey)? What counts as a reduction in joint pain? Telemedicine using remote monitoring technologies can facilitate treatment and even decrease the frequency of virtual and in-person patient encounters. Questions addressing the prediction of the course of a disease. Where ever possible, maintain in-person pediatric visits for vaccinations so children remain on schedule. 0000047593 00000 n clinical placements in prison healthcare settings. The statistical test used to answer your PICOT question. Your patientand her wife have lived together for 10 years, and while she doesn't smoke, her partner does. % AHIP Blog. PICOT is an acronym that is used to represent the clinical question: (P) Patient population, or group of patients of interest. This may require additional communication and outreach to the patient by nurses or medical assistants to review and update information regarding the patients medical history, validate that the reason for their visit is complete, accurate, and identifies the need for any necessary ancillary services (i.e. The extensive uptake of telehealth has considerably transformed health care delivery since the beginning of the COVID-19 pandemic and has imposed tremendous challenges to its large-scale implementation and adaptation. 3 0 obj endobj 194 0 obj xU]o@|\l(TU P`klqgD5P$w=XmeWp3^4uUm^&`Fp 0J3N?kzn~`~s@$RSzdr_UMV/`6IG*,f%R!,q1zub:1f)tO|qSPq5L#(gs]K,WL?3y8kTJG:YzI0)R!fw^,,i [)/h Ra hn&0IM,B))\|(,Ucq~vNS~J0%2 G%~sH$u". -dJia,V?w*ky$k9:%~ Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 8 0 R/Group<>/Tabs/S/StructParents 1>> 0000001136 00000 n in new window). Safeguards are required, such as password protection, in order to ensure that issues of confidentiality of patient data are enforced (Lateff, 2011). endobj First, providers need to understand the limitations of delivering care remotely and the implications on their diagnostic capabilities, particularly among providers who have limited prior telehealth experience. 0000049276 00000 n 8. Are ______(P) who have ______(I) compared with those without _______(C) at ________ risk for/of _______ (O) over ________(T)? <><><>2 3 4]/P 20 0 R/Pg 45 0 R/S/Link>> Accessed April 26, 2020. 34 0 obj Please select your preferred way to submit a case. 5600 Fishers Lane https://www.healthaffairs.org/do/10.1377/hblog20200315.319008/full/. endobj 1 0 obj Missed acute coronary syndrome during telephone triage at out-of-hours primary care: lessons from acase-control study. 2 0 obj :&VLp~3H What are the unique barriers or challenges related to blood sugar management in adolescents with TII diabetes? A guide for conducting nursing research at KUMC. Learn more information here. In the text box below, enter text describing the comparator that is being administered and click on the Submit button. Dr. Sikka is the Founder and Chief Medical Officer of SonoStik, LLC and advises Emergency Medical Innovations, LLC. endobj <> Time is implied in two weeks and 24 hours old. Your independent variable. Coronavirus Disease 2019 (COVID-19) and Safety of Older Adults Residing in Nursing Homes. <>27]/P 23 0 R/Pg 196 0 R/S/Link>> What are the qualitative differences in patient experience in telehealth versus in-person interactions with healthcare providers. 45 0 obj . endobj As such,it is often necessary to ask background questions, which ask for moregeneral, foundational knowledge about a disorder, disease, patient population, policy issue, etc. What is the effect ofinstruction via web-based video lectureson the achievement of learning outcomes in among nursing studentscompared to exclusive use of in-person instruction? All clinical staff within a given institution should be aware of these guidance documents and of when to use them. What is the results of the intervention or service/how is success measured? Your null and alternative hypotheses.