Telemedicine saves the day for Avera Well being within the COVID-19 period

Avera Well being, primarily based in Sioux Falls, South Dakota, has been on the forefront of digital care for the reason that mid-Nineteen Nineties. However with the arrival of COVID-19, the group was challenged with revisiting its telehealth technique to cut back virus unfold whereas nonetheless offering important care companies to its rural communities.

Avera undertook a multifaceted strategy to safer coronavirus prognosis and remedy by means of telehealth, together with a COVID-19 hotline, digital visits and a hospital-at-home program. Its internationally acknowledged eCARE mannequin helped to guard clinicians and employees within the emergency division, even once they have been performing high-risk procedures.

Immediate prognosis and remedy

There are a number of keys to Avera’s strategy to promptly diagnosing and treating sufferers throughout a pandemic, stated Dr. Andrew W. Burchett, chief medical info officer at Avera Well being.

“Through the COVID-19 pandemic, Avera, like many healthcare organizations, was challenged with sustaining a excessive degree of take care of its group, whereas lowering the chance of illness unfold amongst sufferers and hospital employees,” he stated.

“It did this by enterprise a multifaceted strategy to prognosis and remedy, utilizing expertise to serve its group’s wants whereas minimizing pointless in-person interactions.”

This technique included 4 essential components.

“First, the COVID Clinic, a course of for coronavirus screening,” Burchett stated. “Sufferers looking for testing name a hotline nurse – who then triages sufferers primarily based on signs, publicity historical past and medical issues, and directs qualifying sufferers to a drive-up COVID testing middle. Sufferers are swabbed of their autos by an worker in acceptable PPE.”

Second is hospital-at-home – distant monitoring for mild-illness COVID-19 sufferers who’re recovering at dwelling.

“Sufferers are given a thermometer and pulse oximeter and report information from these units to the hospital-at-home program run by Avera physicians and nurses,” he defined. 

“Choose sufferers deemed larger threat are given an HRS distant affected person monitoring system and residential oxygen if wanted. The HRS platform gives extra complete information, together with oxygen saturation, weight, blood stress and temperature. It additionally presents sufferers each day questions relating to their signs.

“If sufferers start to decompensate, physicians are instantly capable of triage them for direct admission to the hospital, permitting them to bypass the emergency division and reduce publicity to different sufferers and employees,” he added.

Digital take care of non-COVID-19 sufferers

Third is digital visits for non-COVID-19 sufferers to proceed receiving routine care at dwelling.

“Telemedicine for routine sufferers has change into the brand new customary in main care and subspecialty clinics at Avera,” Burchett defined. “Endocrinology, psychiatry, dermatology and cardiology are a number of specialties the place digital care has been crucial.”

And fourth is Avera eCARE, which permits care for extreme COVID-19 sufferers within the emergency room whereas minimizing threat to hospital employees.

“Avera has embraced this strategy in subspecialties clinics, as nicely, defending physicians who could also be certainly one of just a few medical doctors offering care of their area all through the area,” he famous. 

“Endocrinology, psychiatry, dermatology and cardiology are a number of specialties the place digital care has been crucial. It’s clear from Avera’s mannequin that telemedicine can and must be embraced in all areas of drugs, not simply main care, as a way to forestall the unfold of the virus, cancellation of appointments, and delays in take care of sufferers.”

Different companies, like chaplaincy, social work, case administration and music remedy, have been ready to make use of digital platforms to proceed interacting with sufferers.

Defending sufferers and caregivers

“By embracing a number of types of expertise and having a dedication to adaptability, Avera has been capable of present compassionate care to those most susceptible sufferers and shield them and their caregivers from publicity and illness,” he stated.

When a affected person presents to the emergency division at Avera, they’re first triaged by a employees member on the entrance door to find out if their go to is coronavirus-related or if the affected person is experiencing signs of coronavirus.

“Sufferers triaged as doubtlessly affected by COVID-19 are put in designated rooms within the emergency division – particularly, rooms in a single hallway to forestall non-COVID sufferers from as a lot publicity as potential,” Burchett stated.

“From there, the affected person waits till a nurse enters the room carrying goggles or a face defend, an N95 masks coated by a surgical masks, a surgical robe, and double gloves.

“This nurse makes use of the Avera eCARE system to name a doctor exterior the room, who can then converse with the affected person and do a full historical past,” he continued. “This doctor can both be on website utilizing an iPad, or one of many physicians off website on the Avera eCARE telemedicine hub. The nurse can present preliminary very important indicators, in addition to receive the COVID-19 swab.”

Step-by-step for physicians

As soon as the historical past and swab are obtained, the doctor on website sometimes dons the identical PPE to do a bodily examination or carry out any crucial procedures.

“If a affected person may be very low threat and has solely gentle signs, the doctor could not have to enter the room in any respect,” he stated. “This preliminary triage system permits for the minimal publicity potential for each the doctor and that doctor’s non-COVID emergent sufferers. It additionally saves PPE by permitting for minimal visits into the affected person’s room, as the robe and gloves have to be doffed earlier than exiting.

“The doctor can nonetheless usually test in with the affected person, answering their questions and offering directions as wanted by way of the video system,” he added.

Burchett will provide extra element throughout his HIMSS21 session, “Digital Care within the Age of COVID-19 and Past.” It is scheduled for August 11, from 2:30-3:30 p.m. in Venetian Marco Polo 701.

Twitter: @SiwickiHealthIT

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