Murren-Boezem Joanne, Solo-Josephson Patricia, Zettler-Greeley Cynthia M
Nemours Children's Hospital, Center for Health Delivery Innovation, Orlando, Florida, USA.
Section on Telehealth Care, American Academy of Pediatrics, Itasca, Illinois, USA.
Telemed J E Health. 2021 Oct;27(10):1111-1116. doi: 10.1089/tmj.2020.0461. Epub 2020 Dec 28.
Background:The COVID-19 global pandemic inspired an unprecedented surge in virtual health care. Safety precautions limited in-person urgent care options, despite high patient demand. This study describes how one children's health system redeployed clinical health professionals to expand existing pediatric, urgent care, on-demand telemedicine in the early months of the United States' pandemic response. Patient utilization and visit characteristics during the pandemic are contextualized relative to pre-pandemic, business-as-usual (BAU) operations.
Materials and Methods:This IRB-approved study is a descriptive, retrospective analysis. Key elements of the clinician redeployment process and shift in physician workflow are described. Retrospective data analysis included routine patient and visit characteristics for urgent care, on-demand telemedicine services received January to May 2020. BAU represented telemedicine encounters between January and May 2019.
Results:Twenty-eight redeployed pediatricians and advanced practice registered nurses were trained and credentialed to assist the on-demand pediatrician team on the existing telemedicine platform. During 2020, providers completed 5,055 telemedicine visits, a 168% increase over the same timeframe in 2019. Pre-pandemic visit wait time was 6.29 ± 5.4 min, which increased to 23.25 ± 34.30 min during 2020. Top chief complaints included skin-related concerns (27.9%) and upper respiratory infections (20.2%) and were consistent across years. Patient satisfaction with provider and platform were high.
Discussion:By engaging and training redeployed clinicians during the pandemic response, health care access was maintained for thousands of patients.
Conclusion:Where regulations allow, clinical health professionals can be trained and redeployed rapidly to on-demand telemedicine platforms to successfully meet spontaneous increases in demand for virtual care.
新冠疫情在全球大流行促使虚拟医疗保健出现前所未有的激增。尽管患者需求高涨，但安全预防措施限制了面对面的紧急护理选择。本研究描述了一家儿童健康系统如何在美国疫情应对的最初几个月重新部署临床医疗专业人员，以扩大现有的儿科按需远程医疗服务。与疫情前的正常业务（BAU）运营相比，对疫情期间患者的使用情况和就诊特征进行了背景分析。
这项经机构审查委员会批准的研究是一项描述性回顾性分析。描述了临床医生重新部署过程的关键要素以及医生工作流程的转变。回顾性数据分析包括2020年1月至5月期间接受的紧急护理、按需远程医疗服务的常规患者和就诊特征。BAU代表2019年1月至5月期间的远程医疗会诊。
28名重新部署的儿科医生和高级执业注册护士接受了培训并获得资质，以协助现有远程医疗平台上按需服务的儿科医生团队。2020年期间，医疗服务提供者完成了5055次远程医疗会诊，比2019年同一时间段增加了168%。疫情前的就诊等待时间为6.29±5.4分钟，2020年增加到23.25±34.30分钟。最主要的主诉包括皮肤相关问题（27.9%）和上呼吸道感染（20.2%），且多年来保持一致。患者对医疗服务提供者和平台的满意度很高。
通过在疫情应对期间让重新部署的临床医生参与并进行培训，为数千名患者维持了医疗服务的可及性。
在法规允许的情况下，临床医疗专业人员可以迅速接受培训并重新部署到按需远程医疗平台，以成功满足虚拟医疗服务需求的突然增加。
