When the Doctors get Sick with Coronavirus – How Telemedicine Provides an Answer

(PHILADELPHIA) – Reports of over 100 medical workers from a single institution quarantined to prevent coronavirus COVID-19 spread raise the looming problem of workforce shortage among healthcare providers. At institutions with established telehealth programs providing secure video-calls with physicians, quarantined doctors can pick up some of the workload. A single quarantined physician can remotely provide coverage for multiple areas from home.

A new perspective in New England Journal of Medicine lays out existing telehealth infrastructure deployed for COVID-19 relief across the country, how health systems and primary-care providers lacking telehealth infrastructure can get up to speed, and the ways in which telehealth interventions are well suited for a pandemic like COVID-19. The article, by Judd Hollander, MD, an Emergency Medicine doctor who leads Jefferson Health’s telemedicine efforts and Brendan Carr, MD, an Emergency Medicine doctor with Icahn School of Medicine at Mount Sinai, New York, was published on March 11, 2020.

Telehealth infrastructure is proving invaluable in the COVID-19 pandemic, from methods aimed at preventing the spread of disease to reducing exposure in-hospital where more advanced cases are treated. Patients have been asked not to walk into urgent-care centers if they think they might be sick, but rather to call ahead or use telehealth. Many health systems currently use telemedicine for emergency consultations, and can continue to use these to help triage patients who think they might be sick.

Some organizations have implemented telehealth intensive-care monitoring programs allowing physicians to track the most fragile patients remotely. Similar efforts can be implemented with two tablets for COVID-19 patients in the hospital to reduce risks for healthcare workers while continuing to monitor and care for those with more serious disease.

Even with the best precautions, the healthcare workforce is not inexhaustible. There will continue to be a need for physicians, nurses, and hospital staff on the ground interacting directly with patients. However, telehealth is an essential tool that acts as both a buffer and a form of relief for front-line workers.

Telemedicine efforts currently in effect at Thomas Jefferson University, in Philadelphia:

• On-demand service with JeffConnect to evaluate patients with symptoms of COVID19 or concerns due to travel history. (Over 1,000 patients seen via telehealth since COVID-19 outbreak)
• Place patients who walk into urgent care and the emergency department into private rooms and evaluate them using the two-tablet approach to keep doctors safe.
• See patients via video upon arrival to the emergency department.
• Train over 1000 providers to take care of established patients via telemedicine
• Have switched sick doctors out of in-person shifts into telehealth shifts while COVID19 testing is pending.
• Continue to provide care to non-exposed patients via telemedicine.

Article reference: Judd E. Hollander and Brendan G. Carr, “Virtually Perfect? Telemedicine for Covid-19,” NEJM, DOI: 10.1056/NEJMp2003539, 2020.

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