Keep Calm and Log On: Telemedicine for COVID‐19 Pandemic Response

Abstract

T he field of telemedicine, in which clinicians use remote evaluation and monitoring to diagnose and treat patients, has grown substantially over the past decade. Its roles in acute care medicine settings are diverse, including virtual intensive care unit (ICU) care, afterhours medical admissions, cross coverage, and, most aptly, disaster management. 1 At HealthPartners, a large integrated healthcare delivery and financing system based in the Twin Cities region of Minnesota, we have used provider-initiated telemedicine in hospital medicine for more than 2 years, providing evening and nighttime hospitalist coverage to our rural hospitals. We additionally provide a 24/7 nurse practitioner-staffed virtual clinic called Virtuwell. 2 Because we are now immersed in a global pandemic, we have taken steps to bolster our telemedicine infrastructure to meet increasing needs.SARS-CoV-2, the causative agent of COVID-19, is a novel coronavirus with the capability to cause severe illness in roughly 14% of those infected. 3 According to some estimates, the virus may infect up to 60% of the US population in the next year. 4 As the pandemic looms over the country and the healthcare community, telemedicine can offer tools to help respond to this crisis. Healthcare systems leveraging telemedicine for patient care will gain several advantages, including workforce sustainability, reduction of provider burnout, limitation of provider exposure, and reduction of personal protective equipment (PPE) waste (Table ). Telemedicine can also facilitate staffing of both large and small facilities that find themselves overwhelmed with pandemic-related patient overload (PRPO). Although telemedicine holds promise for pandemic response, this technology has limitations. It requires robust IT infrastructure, training of both nurses and physicians, and modifications to integrate within hospital workflows. In this article, we summarize key clinical needs that telemedicine can meet, implementation challenges, and important business considerations.

Implementing Physical Distancing in the Hospital: A Key Strategy to Prevent Nosocomial Transmission of COVID‐19

“…Additional information may be obtained from patients by calling them on their patient-room phones or by using telemedicine as some hospitals are implementing. 3 For large "mega" teams, split the team into smaller groups to facilitate continuity and easier conversations.…”

Video Consultation During the COVID-19 Pandemic: A Single Center's Experience with Lung Transplant Recipients

“…5 In the United States, telemedicine has been successfully employed in a wide range of specialties. 6,7 Patients with chronic respiratory conditions such as chronic obstructive pulmonary disease 8 or interstitial lung diseases 9 are especially endangered by COVID-19, 10,11 and traveling to specialized health care facilities puts them at additional risk. 12 Lung transplant (LTx) recipients are extremely vulnerable due to their intense immunosuppressive therapy.…”

Patient care modifications and hospital regulations during the COVID-19 crisis created inequality and functional hazard for patients with orthopaedic trauma

“…There has been a paradigm shift in the attitude towards telemedicine in the general public. Virtual meetings and working remotely have been widely adopted throughout the public and private sector [8]. Technology has rapidly expanded to enable continuation of services [9].…”