New research from Massachusetts General Hospital points to the usefulness of electronic consultations, or e-consults, during the COVID-19 pandemic.
Massachusetts General Hospital has launched two new inpatient Virtual Care programs aimed at improving patient care and connecting patients with their loved ones during the COVID-19 pandemic.
Through the collaboration of multiple departments, including the Center for Telehealth, Information Systems (IS), Nursing & Patient Care Services and Social Work, teams secured and programmed devices that were deployed in a matter of days.
Video Intercom Communication System (VICS)
A Video Intercom Communication System (VICS) installed in Mass General inpatient units in March is designed to enhance the clinician-to-patient connection via bedside tablets attached to IV poles.
This newly implemented system provides significant benefits to both patients and staff. An extension of the call button, VICS allows patients and clinicians to communicate virtually, which helps to reduce the potential spread of infection and decreases the amount of personal protective equipment (PPE) needed when entering the room of a patient with COVID-19.
“This technology enables staff to still connect with patients in a meaningful way, and allows a patient to still see their caregiver even if they can’t be in the room together at all times,” says Sue Algeri, RN, associate chief nurse of Surgical, Orthopedics and Neurosciences. “It provides an additional way for a patient to reach a caregiver if needed, and allows nurses to conduct visual checks on patients even if they didn’t call. We have found this to be another way we are able to enhance patient safety.”
Nearly 600 iPads were taken from closed outpatient units and repurposed to use in the inpatient units. Keith Jennings, chief information officer at Mass General, says the project was not without challenges. A team charged with overseeing the deployment in departments throughout the hospital had to first identify the most efficient way to safely and efficiently display the devices, which was found to be attaching them to IV poles.
“We had to pull together things we had on the shelves, like clamps to secure the iPads to the IV poles, repurpose and reconfigure that equipment, and it takes a lot of work to take something to go from zero to 100 and implement,” says Jennings. “We had staff help to clearly outline the necessary technological information and create a helpful set of instructions for staff and patients. Then we had to scour the country to find clamps that would work—thankfully, Materials Management immediately volunteered to help us with that.”
To date, more than 12,000 interactions have been conducted across 28 units on the VICS platform.
The VICS program has continued to grow since its inception. “Any time a unit would be transitioned to a COVID-19 unit, we would include VICS as part of the rollout,” Algeri says. On April 3, an interpreter function was added to its platform and since that time, there have been more than 60 encounters with staff from Mass General Interpreter Services. Teams continue to deploy devices on units as quickly as possible. New devices are installed on additional units on an as-needed basis, as quickly as possible.
“Our work in this virtual arena will really help us to inform and change our capabilities and processes in the future,” Jennings says. “There are many situations that would see a benefit by having an interactive device in the room and it’s really opening our eyes.”
Mass General also has developed a new program to ensure a virtual connection between patients and their loved ones as most in-person visits are currently not possible due to the COVID-19 pandemic.
Facilitated by the Nursing & Patient Care Services, the Center for Telehealth, Social Work and IS, PatientConnect provides inpatient units with 80 reprogrammed secure, phones and iPads on which patients can receive video calls from family members and loved ones.
To date, Mass General has had about 400 PatientConnect calls since the program launched two weeks ago.
“Patients are here by themselves without their usual support system,” Algeri says. “We wanted to bring patients and loved ones together in a virtual way, so families can provide support, encouragement and share their love. This is something we can offer at a time when they can’t physically be here. Having this kind of connection and being part of that experience is critically important and something we can’t lose sight of during this crisis. We have to continue to bring humanity to our care.”
The one-step process for initiating a call involves visiting a custom Mass General website that provides simple instructions to connect the patient with their family, a consulting physician, or anyone not physically present on the unit. The site also has been translated into several languages, including Spanish, Haitian Creole, Portuguese and Chinese.
“The process that we have set up to implement this program is fairly involved, but staff were fully committed to making it work,” says Jennings. “There is a lot of work for the clinicians to get a call organized for a family member and patient, but they are eager to do so and spend that critical time to make sure the patient is connected.”A separate donation of 100 Amazon Fire tablets will also be distributed to patients who do not have their own devices at the hospital or at home. These tablets will serve as personal devices for patients to connect with family and loved ones while admitted at the hospital, and to bring home upon their discharge.
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