Onsite telemedicine strategy for coronavirus (COVID-19) screening to limit exposure in ED

Abstract

Coronavirus (severe acute respiratory syndrome coronavirus 2) outbreak is a public health emergency and a global pandemic. During the present coronavirus disease (COVID-19) crisis, telemedicine has been recommended to screen suspected patients to limit risk of exposure and maximise medical staff protection. We constructed the protective physical barrier with telemedicine technology to limit COVID-19 exposure in ED. Our hospital is an urban community hospital with annual ED volume of approximately 50 000 patients. We equipped our patient exam room with intercom and iPad for telecommunication. Based on our telemedicine screening protocol, physician can conduct a visual physical examination on stable patients via intercom or videoconference. Telemedicine was initially used to overcome the physical barrier between patients and physicians. However, our protocol is designed to create a protective physical barrier to protect healthcare workers and enhance efficiency in ED. The implementation can be a promising protocol in making ED care more cost-effective and efficient during the COVID-19 pandemic and beyond.

Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic

“…Additionally, on March 17th, 2020 the U.S. Department of Health and Human Services Office for Civil Rights mentioned that during the COVID-19 health emergency, medical practitioners may telemedicine solutions [20], such as MyChart to support patient care [14,15,24]. Likewise, the White House Coronavirus Task Force have advised medicalcenters to expand their adoption of telemedicine for patient assessment [25].…”

“…Thus, provisionally suspending the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 requirement for an in-person assessment before issuing prescription. Besides, state licensing boards are temporarily removing barriers to inter-jurisdictional telemedicine practice for medical practitioners [25]. Similarly, the American Medical Association has expressed a number of recommendations for ethical practice of telemedicine with which medical practitioners should be familiar before they use telemedicine for treatment [14].…”

“…Although, telemedicine can aid in remote assessment (triage) and continuity of medical-care, it is a disruptive process [28]. Several physicians had concerns regarding patient privacy policies, or whether telemedicine assessment was acceptable or meet the needed standards for a complete medical examination [25]. Thus, there is need to consider the challenges that may impact the successful use of telemedicine such as patient's data confidentiality which must be established.…”

“…Furthermore, as reported by [32], technical issue linked to internet access [24], Wi-Fi signal and bandwidth connectivity [25] impact the use of telemedicine. Thus, in some situation some nurses and physicians initially preferred using phone call for consultation as there was not stable enough signal for videoconference.…”

Psychosocial emergency care in times of COVID-19: the Essen University Hospital concept for corona-infected patients, their relatives, and medical staff

“…To maintain the work ability of healthcare professionals during the crisis is essential. Previous studies show that the possibility to use telemedicine during the COVID-19 pandemic is a precious resource to help people without physical contact (Chou et al 2020 ). To support the above-mentioned risk groups, a psychosocial emergency care (PEC) concept has been developed in Essen, Germany.…”