Ipads replace stethoscope
Stanford Health Care has embraced technology to help them treat COVID19 Patients without having close contact with them. As a result, it's keeping medical caregivers from getting sick and saving on thousands of sets of personal protective equipment that doctors and staff would otherwise need to wear when treating patients in person, according to hospital staff.
Patrice Callagy, director of Stanford's emergency services, said that she estimates the hospital is saving a lot of personal protective equipment (PPE) and that healthcare workers are checking in on patients about three times an hour through Zoom, compared to once an hour before when they had to put on and take off all the PPE.
"In a world without telemedicine, we would require three times the amount of PPE, "And that's probably a conservative estimate."
Patients are screened by Virtual Doctors
For those people concerned that they have COVID-19, the telemedicine approach starts when the person arrives at the hospital. Dr. Sam Shen, an emergency department physician and clinical associate professor of emergency medicine at Stanford Medicine, said that patients — if referred to have a COVID-19 test — go to a drive-thru testing area where they are screened for the virus.
Patients who meet the criteria are referred to a triage area inside the hospital parking garage adjacent to the emergency room. A photo is taken of the patient's driver's license and their identifying information is digitally sent to the registration clerk.
Driving into the garage, the patient encounters a nurse and a technician who check the patient's oxygen level and heart rate. They swab the patient's nasal cavity for the virus. Using a two-way camera, a physician in the emergency department examines the patient while they are still in their car. The doctor interviews the patient and checks for signs such as the sound and frequency of a cough, the patient's appearance and other symptoms.
Patients who are sick enough to need possible hospital admission are taken in through a door to an isolation room or enclosed, negative-pressure room from which air does not circulate through the rest of the building. There, a telemedicine cart with an iPad allows a physician to communicate with and further examine the patient remotely. When a patient is admitted to the hospital, the admitting physician can do an assessment and reassessments without going into the room.
What are the benefits of using this new technology?
The hospital started talking about the possibility of using iPads in this way around mid-March and the program has been fully in place since the end of the month.
Callagy added that an unexpected benefit that she saw from the use of the devices was how much better patients seemed to connect with healthcare workers once they could see their faces without goggles and masks.
Another benefit to telemedicine is that thousands of pieces of personal protective equipment — gowns, masks, gloves, eye protection and the like — don't have to be used by health care workers, which is especially important given the current critical shortage of the gear.
How is telemedicine increasing productivity?
Telehealth now makes up about 40% of all clinical visits throughout the entire Stanford Health Care system, 50 times higher than in prior months, according to the hospital.
Telehealth is also helping keep staffing levels more stable during the virus outbreak. Some doctors and staff who were exposed to the virus and are in quarantine are seeing patients from their homes, Sharp said.
"We have people logging in from home and saying, 'I'll take the next patient,'" he said.
Although it is some months away, Stanford is looking at attaching other technological tools to telehealth visits, such as an electronic stethoscope, home blood pressure cuffs, continuous glucose monitors and scopes that patients can place in their ears and throats.
The medical center has for some time-integrated telemedicine — online and video office visits and in-hospital consultations via video and iPad — in its medical settings. But the COVID-19 epidemic in the Bay Area has forced a rapid mainstreaming of virtual tools at the hospitals with a fast expansion within weeks of the outbreak.