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Telemedicine During the COVID-19 Coronavirus Pandemic: Best Practices for Assessing Patients Remotely

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Countries around the world are putting citizens on lockdown in an effort to contain the spread of the COVID-19 pandemic. Social distancing is essential for avoiding the novel coronavirus that causes the disease, but other healthcare concerns will not be put on pause during the crisis—in fact, mental health professionals are seeing a jump in calls in recent days. Telemedicine is one way that healthcare providers can continue meeting the needs of patients, while doing their part to limit in-clinic visits that put both you and your patients at risk.

There have never been more options for connecting with patients in their own homes, with many Internet-based communication technologies and healthcare tools to choose from. These tools will help you, as a healthcare provider, to do your part in keeping people out of clinics and hospitals unless absolutely necessary.


Remote Cognitive Testing: An Overview

Cognitive testing used to require a trained specialist in the same room with the person being assessed, using physical equipment, verbal instructions, and manual scoring sheets to get a report on patient cognition. With the proliferation of personal computer technology and the rise of the Internet, that is no longer necessary—cognitive assessments can be administered to almost anybody, remotely, with no compromise in validity.

The computerized tasks in the CBS Health platform were originally designed to conduct large-scale studies involving participants from around the globe. Just recently, the world’s largest sleep study used CBS to assess over 10,000 people in the comfort of their own homes. That amount of data could not have been collected in a laboratory, and it revealed important findings about the relationship between sleep and cognition.

Unsupervised home assessments are as valid as supervised in-person assessments. One recent study using CBS tasks found that results were no different at home than in a laboratory, and this held true for both healthy participants and a Parkinson’s patient population. Computerized cognitive testing has come a long way, and by following some best practices, practitioners can ensure they continue to collect valuable brain health data from patients who are required to stay home.


Best Practices for Administering Remote Cognitive Assessments

Given these recent events, there has been a significant spike in the number of providers who have asked us for guidance regarding how to administer assessments remotely using CBS Health. If this is an option for you, below you will find several best practices to ensure that you are continuing to collect important cognitive data.

Please note: Our team members are happy to set up a call with you to provide product training on remote assessment capabilities and best practices—simply email us at help@cambridgebrainsciences.com to set up a session today, or schedule a time with us that works best for you via the button below:

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Preparing patients for the assessment virtually:

  • Before an assessment is sent, consider sending an email communication directly from you to the patient to ensure your patient has the information they need for a successful assessment attempt. You can find a sample template to work off of by clicking here.
  • Share the Introduction to CBS Health for Patients document to ensure patients understand the service and can take steps to prepare their environments for home assessments, such as reducing distractions.
  • If you have the opportunity to speak to patients on the phone or via video conference before they are expected to complete the assessment, you may wish to review our Preparing Patients for CBS Health guide—this can be a helpful script or reference to appropriately onboard patients onto the assessment.


Sending patients assessment links via email:

  • Consider customizing the copy in assessment link emails to ensure you are repeating important information throughout the assessment process. To do this, send us a note at help@cambridgebrainsciences.com and we’ll update your account with custom copy immediately.
  • Consider using automatic scheduling (learn more by clicking here) to reduce any administration burden. CBS Health includes scheduling features that require no manual effort after a schedule has been set for a patient.
  • If you typically observe patients as they complete assessments, you can still do so through video conferencing. To monitor how patients are progressing, ask them to enable their cameras and to share their assessment screens. This will largely reproduce observations you would otherwise make in person.


Sharing and communicating of results:

  • CBS Health reports are presented in PDF format, which makes them easy to share with patients via email or a screen-share online service.
  • When possible, use video conferencing software to communicate results, discuss the implications, and even deliver treatments in some cases. There are many secure video conferencing and telehealth options made specifically to facilitate patient interactions, like eVisit in the U.S. or OnCall Health in Canada. Zoom is a popular choice as well, and has features specifically designed for healthcare.


Managing Mental Health During Periods of High Stress

Another factor to consider is that mental health often suffers in times of crisis. Professionals working in the mental health space may see increased need for their services, and those measuring brain health may directly observe the effects of stress and anxiety on cognitive performance.

Part of the problem with anxiety is that worrying takes up cognitive resources—it’s hard to keep information in memory or inhibit distracting thoughts when anxiety is front and center. In our recent sleep study, individuals who suffer from anxiety performed significantly lower on tasks relying on short-term memory, such as Spatial Span, Token Search, and Paired Associates. Attentional control is also difficult to maintain when anxiety is high, and tasks that require response inhibition, such as Double Trouble, have also been found to suffer when anxiety is high.

Some anxiety is normal and healthy in response to a situation like this. However, patients with existing anxiety disorders, or other mental health conditions such as depression, may find themselves more overwhelmed than usual. Let patients know that disruptions like COVID-19 do affect cognition—anxiety, distraction, and brain fog may interfere with cognitive assessments.

Continuing to keep in touch with healthcare providers remotely is one way to fight these effects and regain control in an overwhelming situation, and it is important for individuals and society as a whole to maintain as much cognitive ability as possible during these types of stressful events.


The Effectiveness of Telemedicine During the COVID-19 Pandemic

The effectiveness of telemedicine depends on the specific type of treatment, but it has proven to benefit patient health and cost effectiveness in several areas of healthcare.

The COVID-19 pandemic will further emphasize the benefits of moving some healthcare functions online. Telemedicine has been called a “safety valve for a strained health care system,” experts are recommending virtual doctor visits whenever possible, and the U.S. government has just taken steps to expand Medicare coverage for telehealth.

Web-based cognitive assessments will help you play your part. We here at Cambridge Brain Sciences wish your practice success as we all get through this challenge together, and hope you and your patients avoid its most devastating effects.

As always, let us know if we can help—as mentioned above, our teams are happy to meet with you one on one to review these best practices. To book a time with a CBS team member, please click here.

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