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Bains J, Greenwald PW, Mulcare MR, Leyden D, Kim J, Shemesh AJ, Bodnar D, Farmer B, Steel P, Tanouye R, Kim JW, Lame M, Sharma R. Utilizing Telemedicine in a Novel Approach to COVID-19 Management and Patient Experience in the Emergency Department. Telemed J E Health 2020; 27:254-260. [PMID: 32821027 DOI: 10.1089/tmj.2020.0162] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: The COVID-19 crisis has highlighted telemedicine as a care delivery tool uniquely suited for a disaster pandemic. Introduction: With support from emergency department (ED) leadership, our institution rapidly deployed telemedicine in a novel approach to large-scale ED infectious disease management at NewYork-Presbyterian/Weill Cornell Medical Center (NYP/WCMC) and NewYork-Presbyterian/Lower Manhattan Hospital (NYP/LMH). Materials and Methods: Nineteen telemedicine carts were placed in COVID-19 isolation rooms to conserve personal protective equipment (PPE) and mitigate infectious risk for patients and providers by decreasing in-person exposures. Results: The teleisolation carts were used for 261 COVID-19 patient interactions from March to May 2020, with 79% of overall use in March. Our urban academic site (NYP/WCMC) had 173 of these cases, and the urban community hospital (NYP/LMH) had 88. This initiative increased provider/patient communication and attention to staff safety, improved palliative care and patient support services, lowered PPE consumption, and streamlined clinical workflows. The carts also increased patient comfort and reduced the psychological toll of isolation. Discussion: Deploying customized placement strategies in these two EDs maximized cart availability for isolation patients and demonstrates the utility of telemedicine in various ED settings. Conclusions: The successful introduction of this program in both academic and urban community hospitals suggests that widespread adoption of similar initiatives could improve safe ED evaluation of potentially infectious patients. In the longer term, our experience underscores the critical role of telemedicine in disaster preparedness planning, as building these capabilities in advance allows for the agile scaling needed to manage unforeseen catastrophic scenarios.
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Affiliation(s)
- Jaskaran Bains
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Peter W Greenwald
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Mary R Mulcare
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - David Leyden
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Joshua Kim
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Amos J Shemesh
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - David Bodnar
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Brenna Farmer
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Peter Steel
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Robert Tanouye
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Ji Won Kim
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Maria Lame
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
| | - Rahul Sharma
- NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York City, New York, USA
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