New York Metropolis’s NYU Langone Well being had been investing in telemedicine for a number of years earlier than the COVID-19 pandemic and had all the time been keenly conscious of the vital position expertise would play in the way forward for healthcare.
The group has supplied providers equivalent to digital pressing care, telepsychiatry and digital post-op appointments for a number of years to fulfill the wants of sufferers. Telemedicine will not be solely cost-effective for each the affected person and the hospital, it can also scale back the danger of publicity to illness for all events, particularly throughout a pandemic.
As a result of NYU Langone already had a strong telemedicine infrastructure in place when COVID-19 hit New York, it was in a position to scale its expertise to accommodate for the inflow of sufferers, mentioned Dr. Paul Testa, chief medical data officer at NYU Langone Well being and assistant professor within the Ronald O. Perelman Division of Emergency Medication on the NYU Grossman Faculty of Medication.
“Nonetheless, we had been nonetheless challenged to remain patient-centric at such a big scale and stay built-in throughout all of our campuses,” Testa mentioned. “Our NYU Langone Well being app permits sufferers to entry their well being information, talk with physicians and schedule digital appointments throughout all NYU Langone services, streamlining their expertise.”
The group additionally has invested in expertise that permits physicians to just about observe COVID-19 inpatients to cut back their publicity to the virus and scale back the usage of beneficial private protecting tools (PPE).
When NYU Langone established its telemedicine program a few years in the past, it was not seeking to resolve a right away downside; somewhat, it was serious about what the way forward for care would seem like.
“The panorama of drugs was starting to shift, and it was clear that sufferers did not need to journey far or wait hours to see a physician for issues that could possibly be addressed via a video go to,” Testa defined. “We invested in our telemedicine answer – built-in into our enterprise digital well being report – to supply a handy and cost-effective complement to in-person visits and streamline affected person care.”
The problem was to offer those that search care from the group with the perfect digital affected person expertise – one which was intuitive and built-in, and valued their well being data, he added.
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MEETING THE CHALLENGE
Early final 12 months, NYU Langone transformed convention rooms and working theaters throughout all of its campuses (together with on Lengthy Island and in Brooklyn, in addition to in Manhattan) into ICU services to deal with COVID-19 sufferers.
“Working with Epic, Cisco and Apple as companions, we created clinician-to-clinician video capabilities for physicians to debate affected person care and share remedy recommendations,” Testa recalled. “We additionally created cellular bedside video carts that allowed physicians to talk to sufferers just about from a protected distance and doc their signs in Epic’s MyChart.”
“Working with Epic, Cisco and Apple as companions, we created clinician-to-clinician video capabilities for physicians to debate affected person care and share remedy recommendations. We additionally created cellular bedside video carts that allowed physicians to talk to sufferers just about from a protected distance and doc their signs in Epic’s MyChart.”
Dr. Paul Testa, NYU Langone Well being
Constructed into these units was an automatic pickup system that enabled physicians to dial into the rooms of sufferers who had been intubated or in any other case unable to reply and monitor their situation just about. With out the necessity to scrub in each time they entered the affected person’s room, NYU Langone physicians had been ready to make use of much less PPE and verify on sufferers extra steadily.
As a result of NYU Langone had an present telehealth infrastructure in place, it scaled its scheduling programs to accommodate the uptick in digital appointments and ambulatory visits. Earlier than COVID-19, the group was conducting round 25 to 50 digital visits a day; on the peak of the pandemic, that rose to shut to eight,000 digital appointments in a single day.
“NYU Langone additionally was in a position to remodel convention rooms and places of work into ICU remedy services for COVID-19 sufferers,” Testa famous. “This helped deal with the issue of mattress shortage and allowed physicians to watch ICU sufferers from a protected distance, lowering their publicity and reserving PPE.
“Our group additionally created greater than 1,000 bedside tablets and telemedicine carts, which allowed for video and voice calls between sufferers and their physicians and households,” he continued. “Clinicians may video chat with sufferers about their signs, entry their check outcomes on MyChart and take notes about their care on the HIPAA-compliant units.”
As well as, and of super significance, these tablets allowed sufferers to attach with their family members on the peak of the pandemic, he added. And in some circumstances, it allowed them to make use of the expertise to say goodbye to family members once they had been affected by extreme circumstances of COVID-19 within the ICU and sufferers couldn’t bodily see their households.
USING FCC AWARD FUNDS
Final 12 months, the FCC telehealth funding program awarded NYU Langone Well being $983,772 to make use of telehealth in working rooms and convention room areas which have been transformed into ICUs so medical doctors and healthcare suppliers can rigorously monitor ICU sufferers from separate flooring, thus magnifying the finite variety of obtainable ICU specialists, lowering publicity to the coronavirus and maximizing the restricted provide of non-public protecting tools.
“NYU Langone used the FCC funds to quickly develop, scale and improve our foundational, present, confirmed telemedicine providers throughout all our campuses in addition to greater than 350 ambulatory places,” Testa mentioned. “We quickly cycled new applications via improvement to handle the challenges COVID-19 wrought upon our sufferers and the way we delivered care, bringing video to the bedside, examination room and sufferers’ properties, and digitally connecting their households and caregivers.”
As well as, the FCC assist helped speed up distant affected person monitoring, additionally deeply built-in into the group’s EHR, supporting asynchronous knowledge monitoring of sufferers, serving to to speed up protected discharges whereas remaining related to sufferers.
“Foundationally, the FCC grant allowed us to quickly mature the digital affected person expertise and telemedicine to construct upon a brand new mannequin of supply that’s built-in, handy and of the best high quality,” he concluded.