Preliminary Assessment of a Telehealth Approach to Evaluating, Treating, and Discharging Low-Acuity Patients With Suspected COVID-19.
Preliminary Assessment of a Telehealth Approach to Evaluating, Treating, and Discharging Low-Acuity Patients With Suspected COVID-19.
- 2020
BACKGROUND: Telemedicine is uniquely positioned to address challenges posed to emergency departments (EDs) by the Coronavirus Disease 2019 (COVID-19) pandemic. By reducing in-person contact, it should decrease provider risk of infection and preserve personal protective equipment (PPE). CONCLUSION: Telehealth can be safely and efficiently used to evaluate, treat, test, and discharge ED patients suspected to have COVID-19. This workflow reduces infection risks to health care providers, PPE use, and ED-LOS. Additionally, it allows quarantined but otherwise well clinicians to continue working. Copyright (c) 2020 Elsevier Inc. All rights reserved. METHODS: Retrospective chart review was completed 3 weeks after implementation. Metrics include the number of patients evaluated, number of patients discharged without in-person contact, telehealth wait time and duration, collection of testing, ED length of stay (ED-LOS), 72-h return, number of in-person health care provider contacts, and associated PPE use. OBJECTIVES: To describe and assess the early results of a novel telehealth workflow in which remote providers collaborate with in-person nursing to evaluate and discharge well-appearing, low-risk ED patients with suspected COVID-19 infection. RESULTS: Among 302 patients evaluated by telehealth, 153 patients were evaluated and discharged by a telehealth provider with reductions in ED-LOS, PPE use, and close contact with health care personnel. These patients had a 62.5% shorter ED-LOS compared with other Emergency Severity Index level 4 patients seen over the same time period. Telehealth use for these 153 patients saved 413 sets of PPE. We observed a 3.9% 72-h revisit rate. One patient discharged after telehealth evaluation was hospitalized on a return visit 9 days later.
English
0736-4679
*COVID-19/di [Diagnosis]
*COVID-19/th [Therapy]
*Patient Discharge/st [Standards]
*Telemedicine/mt [Methods]
Adult
Humans
Male
Middle Aged
Patient Acuity
Patient Discharge/td [Trends]
Retrospective Studies
Telemedicine/td [Trends]
Triage/mt [Methods]
Triage/td [Trends]
MedStar Franklin Square Medical Center
MedStar Institute for Innovation
MedStar Washington Hospital Center
Emergency Medicine
MedStar Georgetown University Hospital Residents
MedStar Telehealth Innovation Center
National Center for Human Factors in Healthcare
Journal Article
BACKGROUND: Telemedicine is uniquely positioned to address challenges posed to emergency departments (EDs) by the Coronavirus Disease 2019 (COVID-19) pandemic. By reducing in-person contact, it should decrease provider risk of infection and preserve personal protective equipment (PPE). CONCLUSION: Telehealth can be safely and efficiently used to evaluate, treat, test, and discharge ED patients suspected to have COVID-19. This workflow reduces infection risks to health care providers, PPE use, and ED-LOS. Additionally, it allows quarantined but otherwise well clinicians to continue working. Copyright (c) 2020 Elsevier Inc. All rights reserved. METHODS: Retrospective chart review was completed 3 weeks after implementation. Metrics include the number of patients evaluated, number of patients discharged without in-person contact, telehealth wait time and duration, collection of testing, ED length of stay (ED-LOS), 72-h return, number of in-person health care provider contacts, and associated PPE use. OBJECTIVES: To describe and assess the early results of a novel telehealth workflow in which remote providers collaborate with in-person nursing to evaluate and discharge well-appearing, low-risk ED patients with suspected COVID-19 infection. RESULTS: Among 302 patients evaluated by telehealth, 153 patients were evaluated and discharged by a telehealth provider with reductions in ED-LOS, PPE use, and close contact with health care personnel. These patients had a 62.5% shorter ED-LOS compared with other Emergency Severity Index level 4 patients seen over the same time period. Telehealth use for these 153 patients saved 413 sets of PPE. We observed a 3.9% 72-h revisit rate. One patient discharged after telehealth evaluation was hospitalized on a return visit 9 days later.
English
0736-4679
*COVID-19/di [Diagnosis]
*COVID-19/th [Therapy]
*Patient Discharge/st [Standards]
*Telemedicine/mt [Methods]
Adult
Humans
Male
Middle Aged
Patient Acuity
Patient Discharge/td [Trends]
Retrospective Studies
Telemedicine/td [Trends]
Triage/mt [Methods]
Triage/td [Trends]
MedStar Franklin Square Medical Center
MedStar Institute for Innovation
MedStar Washington Hospital Center
Emergency Medicine
MedStar Georgetown University Hospital Residents
MedStar Telehealth Innovation Center
National Center for Human Factors in Healthcare
Journal Article