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纽约市应对新冠疫情期间儿科患者的远程医疗激增情况

Telemedicine Surge for Pediatric Patients in Response to the COVID-19 Pandemic in New York City.

作者信息

Kim Ji Won, Lame Maria, Szalay Leanna, Lefchak Brian, Johnsson Bille, Gogia Kriti, Clark Sunday, Kessler David, Leyden David, Sharma Rahul, Platt Shari

机构信息

Department of Emergency Medicine, NewYork-Presbyterian and Weill Cornell Medicine, New York, New York, USA.

Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.

出版信息

Telemed J E Health. 2021 Oct;27(10):1105-1110. doi: 10.1089/tmj.2020.0413. Epub 2021 Jan 11.

Abstract

Background:Our objective is to describe our pediatric virtual urgent care (VUC) experience at a large urban academic medical center, in response to the COVID-19 pandemic in New York City (NYC).

Materials and Methods:We conducted a retrospective cohort study of our pediatric VUC program of patients less than age 18 years, from March 1 to May 31, 2020. We include data on expansion of staffing, patient demographics, virtual care, and outcomes.

Results:We rapidly onboarded, educated, and trained pediatric telemedicine providers. We evaluated 406 pediatric patients with median age 4.4 years and 53.9% male. Median call time was 5:12 pm, median time to provider was 5.7 min, and median duration of call was 11.1 min. The most common reasons for a visit were COVID-19-related symptoms (36%), dermatologic (15%), and trauma (10%). Virtual care for patients consisted of conservative management (72%), medication prescription (18%), and referral to an urgent care or pediatric emergency department (PED) (10%). Of 16 patients referred and presented to our emergency department, 2 required intensive care for multisystem inflammatory syndrome in children. Oral antibiotics were prescribed for 7.1% of all patients. Only 0.005% of patients had an unplanned 72-h PED visit resulting in hospitalization after a VUC visit.

Conclusion:Pediatric emergency VUC allowed for high-quality efficient medical care for patients during the peak of the COVID-19 pandemic in NYC. Although most patients were managed conservatively in their home, telemedicine also enabled rapid identification of patients who required in-person emergency care.

摘要

背景

我们的目标是描述在纽约市(NYC)应对新冠疫情期间,我们在一家大型城市学术医疗中心开展儿科虚拟紧急护理(VUC)的经验。

材料与方法

我们对2020年3月1日至5月31日年龄小于18岁的儿科VUC项目患者进行了一项回顾性队列研究。我们纳入了人员配备扩充、患者人口统计学特征、虚拟护理及结果的数据。

结果

我们迅速招募、培训并教育了儿科远程医疗服务提供者。我们评估了406名儿科患者,中位年龄4.4岁,男性占53.9%。中位呼叫时间为下午5:12,中位等待医生时间为5.7分钟,中位通话时长为11.1分钟。就诊的最常见原因是新冠相关症状(36%)、皮肤病(15%)和外伤(10%)。对患者的虚拟护理包括保守治疗(72%)、开具药物处方(18%)以及转诊至紧急护理或儿科急诊科(PED)(10%)。在转诊至我们急诊科并就诊的16名患者中,2名因儿童多系统炎症综合征需要重症监护。所有患者中7.1%开具了口服抗生素。在VUC就诊后,只有0.005%的患者计划外72小时内到PED就诊并住院。

结论

在NYC新冠疫情高峰期,儿科紧急VUC为患者提供了高质量的高效医疗服务。尽管大多数患者在家中接受保守治疗,但远程医疗也能够快速识别需要现场紧急护理的患者。

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