School of Medicine, University of California, San Diego, San Diego, CA, United States.
Information Services, University of California San Diego Health, San Diego, CA, United States.
J Med Internet Res. 2021 May 19;23(5):e28845. doi: 10.2196/28845.
With the emergence of the COVID-19 pandemic and shortage of adequate personal protective equipment (PPE), hospitals implemented inpatient telemedicine measures to ensure operational readiness and a safe working environment for clinicians. The utility and sustainability of inpatient telemedicine initiatives need to be evaluated as the number of COVID-19 inpatients is expected to continue declining. In this viewpoint, we describe the use of a rapidly deployed inpatient telemedicine workflow at a large academic medical center and discuss the potential impact on PPE savings. In early 2020, videoconferencing software was installed on patient bedside iPads at two academic medical center teaching hospitals. An internal website allowed providers to initiate video calls with patients in any patient room with an activated iPad, including both COVID-19 and non-COVID-19 patients. Patients were encouraged to use telemedicine technology to connect with loved ones via native apps or videoconferencing software. We evaluated the use of telemedicine technology on patients' bedside iPads by monitoring traffic to the internal website. Between May 2020 and March 2021, there were a total of 1240 active users of the Video Visits website (mean 112.7, SD 49.0 connection events per month). Of these, 133 (10.7%) connections were made. Patients initiated 63 (47.4%) video calls with family or friends and sent 37 (27.8%) emails with videoconference connection instructions. Providers initiated a total of 33 (24.8%) video calls with the majority of calls initiated in August (n=22, 67%). There was a low level of adoption of inpatient telemedicine capability by providers and patients. With sufficient availability of PPE, inpatient providers did not find a frequent need to use the bedside telemedicine technology, despite a high census of patients with COVID-19. Compared to providers, patients used videoconferencing capabilities more frequently in September and October 2020. We did not find savings of PPE associated with the use of inpatient telemedicine.
随着 COVID-19 大流行的出现以及个人防护设备（PPE）的短缺，医院采取了住院患者远程医疗措施，以确保临床医生具备运营能力并拥有安全的工作环境。随着 COVID-19 住院患者数量预计将继续下降，需要评估住院患者远程医疗计划的实用性和可持续性。在本观点文章中，我们描述了在一家大型学术医疗中心快速部署住院患者远程医疗工作流程的使用情况，并讨论了其对 PPE 节省的潜在影响。2020 年初，两家学术医疗中心教学医院在患者床边的 iPad 上安装了视频会议软件。内部网站允许医务人员在任何激活了 iPad 的病房中与患者发起视频通话，包括 COVID-19 患者和非 COVID-19 患者。鼓励患者使用远程医疗技术通过原生应用程序或视频会议软件与亲人联系。我们通过监测内部网站的流量来评估患者床边 iPad 上远程医疗技术的使用情况。2020 年 5 月至 2021 年 3 月，共有 1240 名 Video Visits 网站的活跃用户（平均每月 112.7 次，SD 49.0 次连接事件）。其中，有 133 次（10.7%）连接成功。患者发起了 63 次（47.4%）与家人或朋友的视频通话，并发送了 37 次（27.8%）带有视频会议连接说明的电子邮件。医务人员总共发起了 33 次（24.8%）视频通话，其中大部分通话是在 8 月发起的（n=22，67%）。医务人员和患者对住院患者远程医疗功能的采用率都较低。尽管 COVID-19 患者的人数很多，但在 PPE 充足的情况下，住院医务人员并没有频繁需要使用床边远程医疗技术。与医务人员相比，患者在 2020 年 9 月和 10 月更频繁地使用视频会议功能。我们没有发现使用住院患者远程医疗与 PPE 节省相关。
