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- In the COVID-19 era, there is an urgent need for telehealth programs like VICS
- While stock of personal protective equipment (PPE) grows increasingly limited, and social distancing measures remain in full effect, technology can provide an extra layer of protection between nurses in the unit and the coronavirus
- The Video Intercom Communications System (VICS) program involves placing tablets in COVID-19 patients' rooms so that their nurses in the unit can check on them while also minimizing physical contact and conserving PPE
Health care facilities around the country are making rapid changes to augment care via telemedicine where it can appropriately replace in-person interactions during this COVID-19 crisis. The use of telemedicine technology can provide an extra layer of protection for care providers and help conserve the stock of increasingly limited personal protective equipment (PPE).
As such, a new telehealth program for COVID-patients, prototyped in early-March 2020, has been deployed to hundreds of hospital rooms across the Partners HealthCare network, including those at Massachusetts General Hospital. The prototype was conceived at the Center for TeleHealth, and initially tested by Benjamin Meller, technology operations manager, Juan Estrada, senior director of virtual consults, Lee Schwamm, MD, director of the Center for TeleHealth, executive vice chair of the Department of Neurology and vice president of Partners HealthCare Systems (PHS) Virtual Care, Emergency Preparedness and the nursing team in Bigelow 9.
Before the first COVID-19 patient arrived in the unit, a tablet enabled with the video intercom communications system (VICS) was placed at their bedside. After a successful first night using the system, minor modifications to the model and the development of accompanying documentation, the deployment across Mass General units began to take place, as prioritized by Patient Care Services leadership.
How the VICS Program Works
Rather than enter a patient's room several times each day, nurses in the unit can now check on their patients virtually. The VICS program allows for the care team to call the tablet in the patient's room, which remains on at all times and communicates with the patient without entering the room.
"This seems to be working well to save PPE and to be decreasing the exposure of our providers," says Estrada. "Potentially it is also more convenient and more efficient, in many cases, for the unit staff to work this way."
According to Estrada, launching a new telemedicine service typically requires significant coordination between many different groups before the technology can even progress from prototype to scale. The Center for TeleHealth has been fortunate to effectively collaborate with Mass General Information Services led by Keith Jennings, chief information officer, Patient Care Services, led by Sue Algeri, associate chief nurse and hospital incident command system lead for inpatient response of Patient Care Services, Partners Virtual Care, Medical Interpreter Services, the Center for Innovation in Digital HealthCare as well as the Health Data Initiative and various other groups in making VICS a reality.
With today's circumstances creating an urgent need for a program like VICS, the process must be fast-tracked. In early March, the team vetted the system to make sure it was reliable, sanitary and intuitive enough to allow for rapid adoption of the system.
The History of Telemedicine at Mass General
Mass General has a legacy of developing and implementing telehealth solutions dating back to 1967. The mission of Mass General Center for TeleHealth is to enable more personal, more affordable and more efficient ways of giving care that supports the gathering of patients and providers at the times and places best suited to their needs. Starting with its flagship TeleStroke Program in 1996, Mass General has been providing virtual consultation care for over 20 years. The concept behind the TeleStroke program, pioneered by Dr. Schwamm in the Department of Neurology, has since expanded beyond neurology and into other departments throughout the hospital.
Now, in the midst of the COVID-19 crisis, the Center for TeleHealth, in collaboration with many departments across the organization is helping to develop several telemedicine tools, one being the VICS program.
"Now there are a few hundred VICS devices deployed across the network, made possible through collaboration and integration across Partners’ information systems and virtual care teams. “We expect that number to continue to grow," says Estrada.
Preparing for the Long-term
As the program expands, the telehealth team is now working to ensure they are proactively addressing potential questions and making sure the infrastructure and tools are in place to keep the program running smoothly as it continues to scale. However, implementing telehealth poses more than just technical challenges. It is an operational challenge with many moving parts.
"We are trying to be very careful, because right now this is serving a mission-critical purpose," says Estrada. “For now, it is all about balancing the flexibility and accessibility of this new solution with the reliability and stability that the pandemic demands.”
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