Usage Patterns of a Web-Based Palliative Care Content Platform (PalliCOVID) During the COVID-19 Pandemic

Lai, Lucinda; Sato, Rintaro; He, Shuhan; Ouchi, Kei; Leiter, Richard E.; Thomas, Jane deLima; Lawton, Andrew; Landman, Adam B.; Zhang, Haipeng Mark

doi:10.1016/j.jpainsymman.2020.07.016

Cited by 21 publications

(12 citation statements)

References 17 publications

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“… 36 Even at hospitals with robust palliative care teams, palliative care utilization in the time of the COVID-19 pandemic may be low, 37 and possibly even more so for patients of racial and ethnic minorities. 38 In order to improve access to palliative care services, studies have examined the use of web-based applications, 39 tele-palliative care consultation, 40 , 41 and work-force expansion through training and redeployment of psychiatry trainees. 42 Early involvement at critical junction points, such as in the emergency department, seems effective to redirect goals of care such that patients avoid unwanted medical interventions.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection

Rao

Zaaqoq

Kang

et al. 2021

Am J Hosp Palliat Care

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Background: Critically ill patients with COVID-19 infection on extracorporeal membrane oxygenation (ECMO) face high morbidity and mortality. Palliative care consultation may benefit these patients and their families. Prior to the pandemic, our institution implemented a policy of automatic palliative care consultation for all patients on ECMO due to the high mortality, medical complexity, and psychosocial distress associated with these cases. Objectives: The main objective was to describe the role of the palliative care team for patients on ECMO for COVID-19 infection. The secondary objective was to describe the clinical outcomes for this cohort. Design: Case series. Settings/Subjects: All patients age 18 or older infected by the novel coronavirus who required cannulation on ECMO from March through July of 2020, at an urban, academic medical center in the United States. Inter-disciplinary palliative care consultation occurred for all patients. Results: Twenty-three patients (median age 43 years [range 28-64], mean body mass index 34.9 kg/m2 [SD 9.2], 65% Hispanic ethnicity) were cannulated on ECMO. Eleven patients died during the hospitalization (48%). Patients older than 50 years of age demonstrated a trend toward increased odds of death compared to those younger than 50 years of age (OR 9.1, P = 0.07). Patients received an average of 6.8 (SD 3.7) palliative clinical encounters across all disciplines. The actions provided by the palliative care team included psychosocial support and counseling, determination of surrogate decision maker (for 100% of patients), pain management (83%), and non-pain symptom management (83%). Conclusions: Here, we present one of the first studies describing the patient characteristics, outcomes, and palliative care actions for critically ill patients with COVID-19 on ECMO. Almost half of the patients in this cohort died during their hospitalization. Given the high morbidity and mortality of this condition, we recommend involvement of palliative care for patients/families with COVID-19 infection who are on ECMO. The impact of palliative care on patient and family outcomes, such as symptom control, satisfaction with communication, rates of anxiety, and grief experience merits further investigation.

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Section: Discussionmentioning

confidence: 99%

Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection

Rao

Zaaqoq

Kang

et al. 2021

Am J Hosp Palliat Care

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“…Characteristics of studies. 41,52,54,55,62,69,77,91,102,105,114,117,122] 14 (11.1) April [17,18,21,30,38,42,43,51,53,61,63-65,68,70,73,75,76,81,82,86,87,90,95,100,101,116,125,129,130,138] 31 (24.6) May [13,20,22,24,25,27-29,31,32,34,36,37,40,44,46,48,50,56,58,67,72,78-80,83,84,89,94,96, 99,103,104,108,113,120,124,132,137] 39 (31.0) June[15,16,23,33,35,39,45,47,49,57,59,66,71,74,85,88,93,97,106,107,109,112,123,126,128,131,[133][134][135][136] [16,18,20,25,30,31,36,37,39,41,46,47,49,50,56,58,67,69,70,…”

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confidence: 99%

“…Characteristics of technologies in the studies. [13-22,25,26,28,30,31,33,34,36-45,47,49-51,54-59,62-64,66-76,78,79,82-89,92,93,96,97, 99-103,105,107-116,118,119] 29,32,35,46,52,53,60,61,65,77,80,90,95,104,106,117] 17 (15.7) Both[20,25,29,34,41,44,45,47,49,51,56,58,61,69,70,73,76,80,81,83,86,[89][90][91][93][94][95]101,[104][105][106][107]114,115,119,120,122,123,[125][126][127][128]131,132,135,136] 46 (58.2) Built for purpose[14-16,18,20,23-26,31,34,37-39,47,50,53,54,57,62-64,67,69-72,74-77,87,90,96,97,100,101,107, 108,111,113,115,117,120,137] [26,29,44,45,52,75,78,81,85,88,89,93-95,103,104,106-109,117-119,121,122,124,126-136,138] 17,20-24,26-33,35,40,42,43,46,49,52,53,55,59-62,65-68,74,76,77,79,81,82,84,8...…”

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confidence: 99%

Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review

Abd‐Alrazaq¹,

Hassan²,

Abuelezz³

et al. 2021

J Med Internet Res

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Background Technologies have been extensively implemented to provide health care services for all types of clinical conditions during the COVID-19 pandemic. While several reviews have been conducted regarding technologies used during the COVID-19 pandemic, they were limited by focusing either on a specific technology (or features) or proposed rather than implemented technologies. Objective This review aims to provide an overview of technologies, as reported in the literature, implemented during the first wave of the COVID-19 pandemic. Methods We conducted a scoping review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. Studies were retrieved by searching 8 electronic databases, checking the reference lists of included studies and relevant reviews (backward reference list checking), and checking studies that cited included studies (forward reference list checking). The search terms were chosen based on the target intervention (ie, technologies) and the target disease (ie, COVID-19). We included English publications that focused on technologies or digital tools implemented during the COVID-19 pandemic to provide health-related services regardless of target health condition, user, or setting. Two reviewers independently assessed the eligibility of studies and extracted data from eligible papers. We used a narrative approach to synthesize extracted data. Results Of 7374 retrieved papers, 126 were deemed eligible. Telemedicine was the most common type of technology (107/126, 84.9%) implemented in the first wave of the COVID-19 pandemic, and the most common mode of telemedicine was synchronous (100/108, 92.6%). The most common purpose of the technologies was providing consultation (75/126, 59.5%), followed by following up with patients (45/126, 35.7%), and monitoring their health status (22/126, 17.4%). Zoom (22/126, 17.5%) and WhatsApp (12/126, 9.5%) were the most commonly used videoconferencing and social media platforms, respectively. Both health care professionals and health consumers were the most common target users (103/126, 81.7%). The health condition most frequently targeted was COVID-19 (38/126, 30.2%), followed by any physical health conditions (21/126, 16.7%), and mental health conditions (13/126, 10.3%). Technologies were web-based in 84.1% of the studies (106/126). Technologies could be used through 11 modes, and the most common were mobile apps (86/126, 68.3%), desktop apps (73/126, 57.9%), telephone calls (49/126, 38.9%), and websites (45/126, 35.7%). Conclusions Technologies played a crucial role in mitigating the challenges faced during the COVID-19 pandemic. We did not find papers describing the implementation of other technologies (eg, contact-tracing apps, drones, blockchain) during the first wave. Furthermore, technologies in this review were used for other purposes (eg, drugs and vaccines discovery, social distancing, and immunity passport). Future research on studies on these technologies and purposes is recommended, and further reviews are required to investigate technologies implemented in subsequent waves of the pandemic.

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“…At the onset of the COVID-19 pandemic, the volume of rapidly evolving clinical information necessitated innovation in Emergency Department (ED) information management. 1 , 2 , 3 Among these innovations was our hospital's COVID-19 decision support tool, zsfgCOVID, a digital COVID-19 information source with up-to-date guidelines related to testing, PPE and airway management. 1 Epidemics and other public health crises can expose weaknesses in the organization and delivery of clinical care.…”

Section: Introductionmentioning

confidence: 99%

Building Back Better: Applying Lessons from the COVID-19 Pandemic to Expand Critical Information Access

Schwartz

Stark

Sowa

et al. 2021

The Journal of Emergency Medicine

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Background The COVID-19 pandemic generated an unprecedented volume of evolving clinical guidelines that strained existing clinical information systems and necessitated rapid innovation in Emergency Departments (EDs). Objectives Our team aimed to harness new COVID-19-related reliance on digital clinical support tools to re-envision the storage of and access to all clinical guidelines in our ED. Methods We used a design-thinking approach including empathizing, defining the problem, ideating, prototyping and testing to develop a low-cost, homegrown clinical information hub: E*Drive. To measure impact, we compared web traffic on E*Drive to our legacy cloud-based folder system and conducted a survey of end-users with a validated health technology utilization instrument. Results Our final product, E*Drive, is a centralized clinical information hub storing everything from clinical guidelines to discharge resources. Clinical guidelines are standardized and housed within the high-traffic E*Drive platform to increase accessibility. Since launch, E*Drive has averaged 84 unique weekly users, compared to <1 weekly user on the legacy system. We surveyed 52 clinicians for a total response rate of 47%. Prior to the E*Drive rollout 12.5% of ED clinicians felt confident accessing clinical information on the legacy system, while 76.6% of ED clinicians felt they could more easily access clinical information using E*Drive. Conclusion The COVID pandemic revealed vulnerabilities within our information dissemination system and presented an opportunity to improve clinical information delivery. Centralized web-based clinical information hubs designed around the clinician end-user experience can increase clinical guideline access in the ED.

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Usage Patterns of a Web-Based Palliative Care Content Platform (PalliCOVID) During the COVID-19 Pandemic

Cited by 21 publications

References 17 publications

Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection

Palliative Care for Patients on Extracorporeal Membrane Oxygenation for COVID-19 Infection

Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review

Building Back Better: Applying Lessons from the COVID-19 Pandemic to Expand Critical Information Access

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