madman
Super Moderator
Abstract
Purpose
The purpose of this white paper is to educate health care professionals about the evolution of telemedicine (TM) and to propose a hybrid model that leverages the strengths of traditional in-person medicine as well as virtual medicine while maximizing the safety and quality of men’s sexual health care.
Literature Search Strategy
A literature search focused on the use of TM in urology and men’s health was performed through PubMed/MEDLINE, Embase, and Web of Science (January 1, 2012–April 26, 2022). Keywords included all known permutations of the terminology used to refer to virtual health, care as well as the terminology used to refer to urologic diseases, issues specific to men’s health, and men’s sexual health concerns. Publications that emerged after the literature search that met this criterion also were incorporated. Opinion pieces, letters to the editor, meeting abstracts, and conference proceedings were excluded. Additional resources were retrieved, such as governmental technical reports,legislative updates and reviews, and blogs. This search strategy yielded 1684 records across databases after removal of duplicates. Abstracts from the retrieved records were reviewed for relevance. Relevant publications were defined as those that reported data on any aspect of TM use specific to urology, men’s health, and/or men’s sexual health. If relevance was unclear from the abstract, then the full text of the article was retrieved for a more detailed review. In addition, the published evidence-based practice guidelines relevant to care for erectile dysfunction,Peyronie’s disease, ejaculatory dysfunction, and hypogonadism were retrieved. The most common reasons for article exclusions were a focus on TM use in disciplines other than urology and the absence of data (ie, opinion pieces). After exclusions, a total of 91 publications remained and constituted the evidence base for this paper.
Telemedicine background
-Growth of overall telemedicine market
-Pandemic effects on TM uptake
-Stabilization of uptake
TM and urology
TM in men’s health and sexual health care Pre–COVID-19 studies
-General urology
-Fertility
-Sexual health
-Prostate cancer
COVID-19–era studies
-General urology
-Additional aspects of TM evaluated
-Sexual health
Advantages
Challenges
DTC and men’s health
-Legislative and regulatory landscape
-Fraud and abuse
-Federal legislation
-State bills and licensing
Men’s sexual health: individual disease states and guideline-concordant care
-Erectile dysfunction
-Peyronie’s disease
-Hypogonadism
-Ejaculatory dysfunction
Areas for expansion and future directions
Strengths, limitations, and clinical implications
There are several strengths of this white paper. These include a thorough review of the pre– and post–COVID-19 TM literature relevant to men’s sexual health care that maps the emergence of TM, its urgent implementation in the context of COVID-19, and the current stabilization of use. The technological challenges to the equitable expansion of TM also are noted. In addition, this paper provides an up-to-date synopsis of regulatory and licensure issues post–COVID-19. Furthermore, a proposed hybrid guideline–concordant model of care is described, focused on men’s sexual health and the broader health issues faced by men through the advantages offered by virtual and traditional medicine. Limitations include the fact that this paper provides a snapshot of the current TM landscape; the TM modality is rapidly and constantly evolving. The clinical implications of our literature review and hybrid guideline–concordant model of care are that the safest and highest quality of care for men requires periodic in-person visits with a clinician to carry out a valid diagnostic process and perform appropriate follow-up.
Purpose
The purpose of this white paper is to educate health care professionals about the evolution of telemedicine (TM) and to propose a hybrid model that leverages the strengths of traditional in-person medicine as well as virtual medicine while maximizing the safety and quality of men’s sexual health care.
Literature Search Strategy
A literature search focused on the use of TM in urology and men’s health was performed through PubMed/MEDLINE, Embase, and Web of Science (January 1, 2012–April 26, 2022). Keywords included all known permutations of the terminology used to refer to virtual health, care as well as the terminology used to refer to urologic diseases, issues specific to men’s health, and men’s sexual health concerns. Publications that emerged after the literature search that met this criterion also were incorporated. Opinion pieces, letters to the editor, meeting abstracts, and conference proceedings were excluded. Additional resources were retrieved, such as governmental technical reports,legislative updates and reviews, and blogs. This search strategy yielded 1684 records across databases after removal of duplicates. Abstracts from the retrieved records were reviewed for relevance. Relevant publications were defined as those that reported data on any aspect of TM use specific to urology, men’s health, and/or men’s sexual health. If relevance was unclear from the abstract, then the full text of the article was retrieved for a more detailed review. In addition, the published evidence-based practice guidelines relevant to care for erectile dysfunction,Peyronie’s disease, ejaculatory dysfunction, and hypogonadism were retrieved. The most common reasons for article exclusions were a focus on TM use in disciplines other than urology and the absence of data (ie, opinion pieces). After exclusions, a total of 91 publications remained and constituted the evidence base for this paper.
Telemedicine background
-Growth of overall telemedicine market
-Pandemic effects on TM uptake
-Stabilization of uptake
TM and urology
TM in men’s health and sexual health care Pre–COVID-19 studies
-General urology
-Fertility
-Sexual health
-Prostate cancer
COVID-19–era studies
-General urology
-Additional aspects of TM evaluated
-Sexual health
Advantages
Challenges
DTC and men’s health
-Legislative and regulatory landscape
-Fraud and abuse
-Federal legislation
-State bills and licensing
Men’s sexual health: individual disease states and guideline-concordant care
-Erectile dysfunction
-Peyronie’s disease
-Hypogonadism
-Ejaculatory dysfunction
Areas for expansion and future directions
Strengths, limitations, and clinical implications
There are several strengths of this white paper. These include a thorough review of the pre– and post–COVID-19 TM literature relevant to men’s sexual health care that maps the emergence of TM, its urgent implementation in the context of COVID-19, and the current stabilization of use. The technological challenges to the equitable expansion of TM also are noted. In addition, this paper provides an up-to-date synopsis of regulatory and licensure issues post–COVID-19. Furthermore, a proposed hybrid guideline–concordant model of care is described, focused on men’s sexual health and the broader health issues faced by men through the advantages offered by virtual and traditional medicine. Limitations include the fact that this paper provides a snapshot of the current TM landscape; the TM modality is rapidly and constantly evolving. The clinical implications of our literature review and hybrid guideline–concordant model of care are that the safest and highest quality of care for men requires periodic in-person visits with a clinician to carry out a valid diagnostic process and perform appropriate follow-up.
