Telehealth: Navigating the COVID-19 Pandemic and Beyond: The Sickle Cell Unit Experience

Telemed J E Health. 2023 Dec;29(12):1781-1791. doi: 10.1089/tmj.2023.0100. Epub 2023 Apr 24.

Abstract

Introduction: To examine the use of telehealth for delivery of health care in persons with sickle cell disease in a resource-constrained country during the COVID-19 pandemic. Methods: This study was a retrospective review of patient encounters at the Sickle Cell Unit (SCU), Jamaica during a 3-year period, March 10, 2019 to March 9, 2022 and a comparison of endpoints between 1 year before and 2 years during the pandemic. Primary endpoints of registration numbers, day-care admissions, and study visits were obtained from logbooks and the electronic medical records. Additional endpoints included well visits, hydroxyurea (HU) visits, and bone pain crisis. Results: Patients registered at the clinic on 17,295 occasions, with 7,820 in the pre-pandemic year decreasing by 43.8% and 35% in the 2 subsequent pandemic years. Overall, study visits increased by 4.9% and 1.3% in the pandemic years. They increased in adults by 13.1% and 8.9% but fell by 3.2% and 6.2% in children. Fewer people were seen in the pandemic years, with children showing a 20.7% decline in numbers. Tele-visits accounted for 31.4% of all study visits during the pandemic years and increased by 23.6% between the pandemic years. There were more well-visits and HU visits, but fewer pain visits and day-care admissions in the pandemic years. Conclusions: The SCU maintained health care delivery for a high-risk population during the pandemic, with tele-visits mitigating the short-fall from in-person visits. Tele-visits may be more acceptable to adults with a chronic illness and may be a suitable alternative for delivering health care.

Keywords: COVID-19; Caribbean; Jamaica; resource-constraint; sickle cell; telehealth; telemedicine.

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • Anemia, Sickle Cell* / epidemiology
  • Anemia, Sickle Cell* / therapy
  • COVID-19* / epidemiology
  • Child
  • Humans
  • Hydroxyurea
  • Pain
  • Pandemics
  • Telemedicine*

Substances

  • Hydroxyurea