Inpatient Telehealth Tools to Enhance Communication and Decrease Personal Protective Equipment Consumption during Disaster Situations: A Case Study during the COVID-19 Pandemic

Abstract

Background As the coronavirus disease 2019 pandemic exerts unprecedented stress on hospitals, health care systems have quickly deployed innovative technology solutions to decrease personal protective equipment (PPE) use and augment patient care capabilities. Telehealth technology use is established in the ambulatory setting, but not yet widely deployed at scale for inpatient care.

Objectives This article presents and describes our experience with evaluating and implementing inpatient telehealth technologies in a large health care system with the goals of reducing use of PPE while enhancing communication for health care workers and patients.

Methods We discovered use cases for inpatient telehealth revealed as a result of an immense patient surge requiring large volumes of PPE. In response, we assessed various consumer products to address the use cases for our health system.

Results We identified 13 use cases and eight device options. During device setup and implementation, challenges and solutions were identified in five areas: security/privacy, device availability and setup, device functionality, physical setup, and workflow and device usage. This enabled deployment of more than 1,800 devices for inpatient telehealth across seven hospitals with positive feedback from health care staff.

Conclusion Large-scale setup and distribution of consumer devices is feasible for inpatient telehealth use cases. Our experience highlights operational barriers and potential solutions for health systems looking to preserve PPE and enhance vital communication.

Keywords

video devices - communication - coronavirus - telemedicine - telehealth

• References

• 1 Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis 2020; 20 (05) 533-534
• 2 Johns Hopkins University & Medicine Coronavirus Resource Center. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. Available at: https://coronavirus.jhu.edu/map.html . Accessed August 16, 2020
• 3 Cavallo JJ, Donoho DA, Forman HP. Hospital capacity and operations in the coronavirus disease 2019 (COVID-19) pandemic—planning for the Nth patient. JAMA Health Forum 2020; 1 (03) e200345-e200345
• 4 Ranney ML, Griffeth V, Jha AK. Critical supply shortages - the need for ventilators and personal protective equipment during the Covid-19 pandemic. N Engl J Med 2020; 382 (18) e41
• 5 Mehrotra P, Malani P, Yadav P. Personal Protective Equipment Shortages During COVID-19—Supply Chain–Related Causes and Mitigation Strategies. JAMA Health Forum 2020; 1 (05) e200553-e200553
• 6 World Health Organization. Rational use of personal protective equipment for coronavirus disease (COVID-19) and considerations during severe shortages. 2020 . Available at: https://www.who.int/publications/i/item/rational-use-of-personal-protective-equipment-for-coronavirus-disease-(covid-19)-and-considerations-during-severe-shortages . Accessed October 16, 2020
• 7 Grange ES, Neil EJ, Stoffel M. , et al. Responding to COVID-19: the UW Medicine Information Technology Services experience. Appl Clin Inform 2020; 11 (02) 265-275
• 8 Turer RW, Jones I, Rosenbloom ST, Slovis C, Ward MJ. Electronic personal protective equipment: a strategy to protect emergency department providers in the age of COVID-19. J Am Med Inform Assoc 2020; 27 (06) 967-971
• 9 National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. Using telehealth to expand access to essential health services during the COVID-19 pandemic. Centers for Disease Control and Prevention; . Published June 10, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html. Accessed August 10, 2020
• 10 Wosik J, Fudim M, Cameron B. , et al. Telehealth transformation: COVID-19 and the rise of virtual care. J Am Med Inform Assoc 2020; 27 (06) 957-962
• 11 Hron JD, Parsons CR, Williams LA, Harper MB, Bourgeois FC. Rapid Implementation of an inpatient telehealth program during the COVID-19 pandemic. Appl Clin Inform 2020; 11 (03) 452-459
• 12 Humphreys J, Schoenherr L, Elia G. , et al. Rapid implementation of inpatient telepalliative medicine consultations during COVID-19 pandemic. J Pain Symptom Manage 2020; 60 (01) e54-e59
• 13 Massey PA, McClary K, Zhang AS, Savoie FH, Barton RS. Orthopaedic surgical selection and inpatient paradigms during the coronavirus (COVID-19) pandemic. J Am Acad Orthop Surg 2020; 28 (11) 436-450
• 14 Borchert A, Baumgarten L, Dalela D. , et al. Managing urology consultations during COVID-19 pandemic: application of a structured care pathway. Urology 2020; 141: 7-11
• 15 Trinidad J, Kroshinsky D, Kaffenberger BH, Rojek NW. Telemedicine for inpatient dermatology consultations in response to the COVID-19 pandemic. J Am Acad Dermatol 2020; 83 (01) e69-e71
• 16 Umoren RA, Gray MM, Handley S. , et al. In-hospital telehealth supports care for neonatal patients in strict isolation. Am J Perinatol 2020; 37 (08) 857-860
• 17 Centers for Disease Control and Prevention. Comprehensive hospital preparedness checklist for coronavirus disease 2019 (COVID-19). Centers for Disease Control and Prevention; . Published March 25, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/hcp-hospital-checklist.html. Accessed July 20, 2020
• 18 Office for Civil Rights (OCR). HIPAA, Civil Rights, and COVID-19. HHS.gov Health Information Privacy. Published March 30, 2020. Available at: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html . Accessed July 20, 2020
• 19 Ahmad MS, Musa NE, Nadarajah R, Hassan R, Othman NE. Comparison between android and iOS operating system in terms of security. Paper presented at: 2013 8th International Conference on Information Technology in Asia (CITA); Kota Samarahan, Malaysia; 2013: 1-4
• 20 Arora A, Sharma H, Aggarwal P. Security comparison between android and iOS. Int J Eng Res Technol 2017; 5 (10) 1-5
• 21 Orson D. LISTEN: on the front line at Yale New Haven Hospital. Connecticut Public Radio. Published April 21, 2020. Accessed August 21, 2020 at: https://www.wnpr.org/post/listen-front-line-yale-new-haven-hospital