Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study
BackgroundTelemedicine has been deployed by health care systems in response to the COVID-19 pandemic to enable health care workers to provide remote care for both outpatients and inpatients. Although it is reasonable to suspect telemedicine visits limit unnecessary personal c...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2021-07-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2021/7/e29240 |
| _version_ | 1797735904509427712 |
|---|---|
| author | Birju Patel Stacie Vilendrer Samantha M R Kling Ian Brown Ryan Ribeira Matthew Eisenberg Christopher Sharp |
| author_facet | Birju Patel Stacie Vilendrer Samantha M R Kling Ian Brown Ryan Ribeira Matthew Eisenberg Christopher Sharp |
| author_sort | Birju Patel |
| collection | DOAJ |
| description |
BackgroundTelemedicine has been deployed by health care systems in response to the COVID-19 pandemic to enable health care workers to provide remote care for both outpatients and inpatients. Although it is reasonable to suspect telemedicine visits limit unnecessary personal contact and thus decrease the risk of infection transmission, the impact of the use of such technology on clinician workflows in the emergency department is unknown.
ObjectiveThis study aimed to use a real-time locating system (RTLS) to evaluate the impact of a new telemedicine platform, which permitted clinicians located outside patient rooms to interact with patients who were under isolation precautions in the emergency department, on in-person interaction between health care workers and patients.
MethodsA pre-post analysis was conducted using a badge-based RTLS platform to collect movement data including entrances and duration of stay within patient rooms of the emergency department for nursing and physician staff. Movement data was captured between March 2, 2020, the date of the first patient screened for COVID-19 in the emergency department, and April 20, 2020. A new telemedicine platform was deployed on March 29, 2020. The number of entrances and duration of in-person interactions per patient encounter, adjusted for patient length of stay, were obtained for pre- and postimplementation phases and compared with t tests to determine statistical significance.
ResultsThere were 15,741 RTLS events linked to 2662 encounters for patients screened for COVID-19. There was no significant change in the number of in-person interactions between the pre- and postimplementation phases for both nurses (5.7 vs 7.0 entrances per patient, P=.07) and physicians (1.3 vs 1.5 entrances per patient, P=.12). Total duration of in-person interactions did not change (56.4 vs 55.2 minutes per patient, P=.74) despite significant increases in telemedicine videoconference frequency (0.6 vs 1.3 videoconferences per patient, P<.001 for change in daily average) and duration (4.3 vs 12.3 minutes per patient, P<.001 for change in daily average).
ConclusionsTelemedicine was rapidly adopted with the intent of minimizing pathogen exposure to health care workers during the COVID-19 pandemic, yet RTLS movement data did not reveal significant changes for in-person interactions between staff and patients under investigation for COVID-19 infection. Additional research is needed to better understand how telemedicine technology may be better incorporated into emergency departments to improve workflows for frontline health care clinicians. |
| first_indexed | 2024-03-12T13:04:51Z |
| format | Article |
| id | doaj.art-e0818e9da9bd4fcb8334d25816f88018 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T13:04:51Z |
| publishDate | 2021-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-e0818e9da9bd4fcb8334d25816f880182023-08-28T17:08:23ZengJMIR PublicationsJournal of Medical Internet Research1438-88712021-07-01237e2924010.2196/29240Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational StudyBirju Patelhttps://orcid.org/0000-0001-7673-6143Stacie Vilendrerhttps://orcid.org/0000-0003-2317-5973Samantha M R Klinghttps://orcid.org/0000-0001-9169-763XIan Brownhttps://orcid.org/0000-0003-0656-2621Ryan Ribeirahttps://orcid.org/0000-0002-4782-2410Matthew Eisenberghttps://orcid.org/0000-0003-3970-1886Christopher Sharphttps://orcid.org/0000-0001-7169-6904 BackgroundTelemedicine has been deployed by health care systems in response to the COVID-19 pandemic to enable health care workers to provide remote care for both outpatients and inpatients. Although it is reasonable to suspect telemedicine visits limit unnecessary personal contact and thus decrease the risk of infection transmission, the impact of the use of such technology on clinician workflows in the emergency department is unknown. ObjectiveThis study aimed to use a real-time locating system (RTLS) to evaluate the impact of a new telemedicine platform, which permitted clinicians located outside patient rooms to interact with patients who were under isolation precautions in the emergency department, on in-person interaction between health care workers and patients. MethodsA pre-post analysis was conducted using a badge-based RTLS platform to collect movement data including entrances and duration of stay within patient rooms of the emergency department for nursing and physician staff. Movement data was captured between March 2, 2020, the date of the first patient screened for COVID-19 in the emergency department, and April 20, 2020. A new telemedicine platform was deployed on March 29, 2020. The number of entrances and duration of in-person interactions per patient encounter, adjusted for patient length of stay, were obtained for pre- and postimplementation phases and compared with t tests to determine statistical significance. ResultsThere were 15,741 RTLS events linked to 2662 encounters for patients screened for COVID-19. There was no significant change in the number of in-person interactions between the pre- and postimplementation phases for both nurses (5.7 vs 7.0 entrances per patient, P=.07) and physicians (1.3 vs 1.5 entrances per patient, P=.12). Total duration of in-person interactions did not change (56.4 vs 55.2 minutes per patient, P=.74) despite significant increases in telemedicine videoconference frequency (0.6 vs 1.3 videoconferences per patient, P<.001 for change in daily average) and duration (4.3 vs 12.3 minutes per patient, P<.001 for change in daily average). ConclusionsTelemedicine was rapidly adopted with the intent of minimizing pathogen exposure to health care workers during the COVID-19 pandemic, yet RTLS movement data did not reveal significant changes for in-person interactions between staff and patients under investigation for COVID-19 infection. Additional research is needed to better understand how telemedicine technology may be better incorporated into emergency departments to improve workflows for frontline health care clinicians.https://www.jmir.org/2021/7/e29240 |
| spellingShingle | Birju Patel Stacie Vilendrer Samantha M R Kling Ian Brown Ryan Ribeira Matthew Eisenberg Christopher Sharp Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study Journal of Medical Internet Research |
| title | Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study |
| title_full | Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study |
| title_fullStr | Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study |
| title_full_unstemmed | Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study |
| title_short | Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study |
| title_sort | using a real time locating system to evaluate the impact of telemedicine in an emergency department during covid 19 observational study |
| url | https://www.jmir.org/2021/7/e29240 |
| work_keys_str_mv | AT birjupatel usingarealtimelocatingsystemtoevaluatetheimpactoftelemedicineinanemergencydepartmentduringcovid19observationalstudy AT stacievilendrer usingarealtimelocatingsystemtoevaluatetheimpactoftelemedicineinanemergencydepartmentduringcovid19observationalstudy AT samanthamrkling usingarealtimelocatingsystemtoevaluatetheimpactoftelemedicineinanemergencydepartmentduringcovid19observationalstudy AT ianbrown usingarealtimelocatingsystemtoevaluatetheimpactoftelemedicineinanemergencydepartmentduringcovid19observationalstudy AT ryanribeira usingarealtimelocatingsystemtoevaluatetheimpactoftelemedicineinanemergencydepartmentduringcovid19observationalstudy AT mattheweisenberg usingarealtimelocatingsystemtoevaluatetheimpactoftelemedicineinanemergencydepartmentduringcovid19observationalstudy AT christophersharp usingarealtimelocatingsystemtoevaluatetheimpactoftelemedicineinanemergencydepartmentduringcovid19observationalstudy |