Telemedicine via Smart Glasses in Critical Care of the Neurosurgical Patient—COVID-19 Pandemic Preparedness and Response in Neurosurgery

Abstract

Objective The COVID-19 pandemic poses major risks to healthcare workers in neurocritical care. Recommendations are in place to limit medical personnel attending to the neurosurgical patient as a protective measure and to conserve personal protective equipment. However, the complexity of the neurosurgical patient proves to be a challenge and an opportunity for innovation. The goal of our study was to determine if telemedicine delivered through smart glasses was feasible and effective in an alternative method of conducting ward round on neurocritical care patients during the pandemic. Methods A random pair of Neurosurgery resident and specialist conducted consecutive virtual and physical ward rounds on neurocritical patients. A virtual ward round was first conducted remotely by a specialist who received real-time audiovisual information from a resident wearing smart glasses integrated with telemedicine. Subsequently, a physical ward round was performed together by the resident and specialist on the same patient. The management plans of both ward rounds were compared and the intrarater reliability was measured. On study completion a qualitative survey was performed. Results Ten paired ward rounds were performed on 103 neurocritical care patients with excellent overall intrarater reliability. Nine out of ten showed good to excellent internal consistency and one showed acceptable internal consistency. Qualitative analysis indicated wide user acceptance and high satisfaction rate with the alternative method. Conclusions Virtual ward rounds using telemedicine via smart glasses on neurosurgical patients in critical care were feasible, effective and widely accepted as an alternative to physical ward rounds during the COVID-19 pandemic.

Physician Perspectives on the Impact of the COVID-19 Pandemic on Family-Centered Rounds

“…Despite emerging literature describing hospitals' pandemic responses, most studies are focused on the implementation of technological adaptations for patient care and not on the impact of rounding modifications. [6][7][8][15][16][17][18][19] This study documents previously unreported physician perspectives on FCR changes. Many recommendations reported here have been implemented at our and other institutions and may continue to be relevant during the remainder of this pandemic, during future pandemics, and in situations in which a family member is unable to be physically present or a patient has a highly communicable agent, such as measles.…”

“…Most participants reported difficulty communicating with consultants due to decreased physical presence, although some faculty reported a favorable culture change around texting and/or telephonic communication and virtual rounds with consultants. Virtual team rounds have been described in adult and pediatric settings 7,8,[15][16][17]24 ; virtual rounds with a standardized rounding script led to decreased faculty variation and better inclusion of nurses and physicians. 25 Achieving a shared mental model with the care team is a key FCR principle that may be sustained through technological approaches ranging from telephone calls and messaging to videoconferencing.…”

Reshaping surgical specialist training in small animal surgery during and after theCOVID‐19 pandemic

“…They have displayed improved surgical workflow and provided an opportunity for remote supervision and enhanced surgical education 32 . Their application has also been seen within the pandemic efforts in facilitating virtual ward rounds, which were deemed feasible, effective, and widely accepted as an alternative, under the circumstances 33 …”

Online Synchronous Clinical Communication Training During the COVID-19 Pandemic [Letter]

“…Virtual ward rounds using smart glasses have been successful in giving junior doctors guidance during the COVID-19 pandemic. 3 Similar technology could allow students to witness communication skills in action, whilst not detracting from the work of clinicians.…”