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Coronavirus disease 2019 made us question daily practices, such as the simple handshake. It also raised some ethical and legal issues. Are the ethical principles, that should guide the provision of individualized care, being fulfilled? Will we, as health professionals, be able to provide patients with instruments so that they can fully exercise their autonomy? The guarantee of necessary security solutions, to reduce the risk of contagion in the provision of care, safeguards the principle of non-maleficence. However, the risk of contagion is impossible to completely eliminate, and there is a residual risk associated with the use of physical facilities in healthcare services. But, shouldn't the decision to take that risk be the subject of the patient's free and informed will? The incorporation of telemedicine platforms is ideal for managing several challenges posed by COVID-19, such as the decrease in face-to-face health care assistance. Can the patient really decide how he prefers to be consulted, or are we imposing the consultation model? There have been profound changes in healthcare systems. However, one must remember that there are ethical principles of biomedicine, that should always prevail. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic crisis, among so many social, economic and health problems, also brought new opportunities. The potential of telemedicine to improve health outcomes had already been recognised in the last decades, but the pandemic crisis has accelerated the digital revolution. In 2020, a rapid increase in the use of remote consultations occurred due to the need to reduce attendance and overcrowding in outpatient clinics. However, the benefit of their use extends beyond the pandemic crisis, as an important tool to improve both the efficiency and capacity of future healthcare systems. This article reviews the literature regarding telemedicine and teleconsultation standards and recommendations, collects opinions of Portuguese experts in respiratory medicine and provides guidance in teleconsultation practices for Pulmonologists., (Copyright © 2022 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)

The article presents a study on the ability of teleconsultations in decreasing greenhouse gas emissions. It mentions a comparison of the emissions of patients attending the outpatient appointment that utilizes video-conferencing equipment with those engaged in its face-to-face counterpart. It also notes that 95% of emissions, 2,313,819 kilometers (km) of travel and 455 tonnes of greenhouse gas emanation were avoided through the first appointment.

Introduction: The COVID-19 pandemic led to the reorganization of healthcare services and teleconsultation emerged as a solution to facilitate patient appointments. The aim of this study was to characterize, from a physician perspective, the teleconsultations carried out in the Portuguese National Health Service (SNS) during the first phase of the pandemic and to identify factors that influence the experience of the teleconsultation., Material and Methods: A cross-sectional analytical study was conducted based on an online survey, between July-September 2020, aimed at SNS doctors. Data on demographics, practice, attitudes and perceptions associated with the teleconsultation was collected. The adjusted prevalence ratio (aPR) was calculated to identify demographic factors and determinants of teleconsultation associated with satisfaction, use of video calls and greater motivation to carry out teleconsultations in the future., Results: 2225 valid responses were obtained. Teleconsultation was carried out by 93.8% of participants in this period, 99.0% used the telephone as a form of communication and only 8.0% used a video call. A high degree of satisfaction with the teleconsultation was significantly associated with perceiving the teleconsultation as providing care with equivalent quality to a face-to-face consultation (aPR = 1.472) and being motivated to do teleconsultation after the pandemic (aPR = 4.081). Reporting clinical (aPR = 0.763) or technical difficulties (aPR = 0.666) was negatively associated with satisfaction). 70.4% of doctors would like to continue doing follow-up teleconsultations and 53.3% consider that video call technologies should always or often be used during teleconsultations., Conclusion: Teleconsultation seems to have potential to to become a common practice in the future. However, it is important to address clinical, technical, organizational, and legal questions and, above all, to ensure that it is a safe and valuable practice for patients.

Background and Aims: As the COVID-19 pandemic emerged, departments had to adapt their activities, jeopardizing patient's best interests. Our aim is to evaluate the patient's perspective to the implementation of SARS-CoV-2 measures in a gastroenterology department in a Portuguese Hospital., Methods: A survey with 13 questions was created and available to patients with at least one gastroenterology appointment at our center in the year 2019., Results: Nine hundred seventy-three patients completed the survey, 51.6% (n = 502) females, and 82.6% (n = 804) with less than 65 years of age. 50.7% of 962 patients were not working. 49.5% had an appointment for monitoring a suspected or established inflammatory bowel disease (IBD). 76.8% and 69.6% subjects agreed in postponing endoscopic and non-endoscopic procedures, respectively. 93.6%, 94.3% and 95.7% patients declared to be worried about the postponing of endoscopic procedures, non-endoscopic procedures and medical visits, respectively. 88.8% supported remote consultations and 77.3% were satisfied with this type of appointment, independently of the age group (P = 0.66). 80.9% of IBD patients treated with immunosuppression or biologics were concerned about a severe infection by COVID-19., Conclusion: A great part of our respondents belong to IBD appointments. The majority of our patients agreed in postponing procedures, although they feel concerned. Almost all patients supported remote consultations and most patients found them positive., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)