A Case for Telestroke in Military Medicine: A Retrospective Analysis of Stroke Cost and Outcomes in U.S. Military Health-Care System

Dave, Ajal; Cagniart, Kendra; Holtkamp, Matthew D.

doi:10.1016/j.jstrokecerebrovasdis.2018.04.018

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…This model, which has previously been studied in telemedicine with signs of successful implementation, is now being studied in the setting of COVID-19. 5,6 However, with the ongoing pandemic, it is difficult to conduct high quality iterative testing of this model, but simulation affords a powerful tool to allow for expedited testing of such a solution.…”

Section: Introductionmentioning

confidence: 99%

Pilot Testing of Simulation in the Evaluation of a Novel, Rapidly Deployable Electronic Health Record for use in Disaster Intensive Care

Applebury

Robinson

Gold

et al. 2021

Disaster med. public health prep.

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Objectives: The SARS-CoV-2 pandemic has highlighted the need for rapid creation and management of ICU field hospitals with effective remote monitoring which is dependent on the rapid deployment and integration of an Electronic Health Record (EHR). We describe the use of simulation to evaluate a rapidly scalable hub-and-spoke model for EHR deployment and monitoring using asynchronous training. Methods: We adapted existing commercial EHR products to serve as the point of entry from a simulated hospital and a separate system for tele-ICU support and monitoring of the interfaced data. To train our users we created a modular video-based curriculum to facilitate asynchronous training. Effectiveness of the curriculum was assessed through completion of common ICU documentation tasks in a high-fidelity simulation. Additional endpoints include assessment of EHR navigation, user satisfaction (Net Promoter), system usability (System Usability Scale-SUS), and cognitive load (NASA-TLX). Results: A total of 5 participants achieved a 100% task completion on all domains except ventilator data (91%). Systems demonstrated high degrees of satisfaction (Net Promoter = 65.2), acceptable usability (SUS = 66.5), and acceptable cognitive load (NASA-TLX = 41.5); with higher levels of cognitive load correlating with the number of screens employed. Conclusions: Clinical usability of a comprehensive and rapidly deployable EHR was acceptable in an intensive care simulation which was preceded by < 1 hour of video education about the EHR. This model should be considered in plans for integrated clinical response with remote and accessory facilities.

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Section: Introductionmentioning

confidence: 99%