The use of video visits has been critical during the COVID-19 pandemic to connect doctors with patients at home to minimize exposure to the virus.
Virtual health has been just as crucial inside the walls of hospitals to keep providers and patients safe.
As the nation’s hospitals continue to fill up and visitors are again restricted, healthcare providers are faced with the ongoing challenges of protecting patients and clinicians while also keeping patients connected to loved ones and care teams.
Taking advantage of its robust telehealth platform and bedside digital tools in its hospital patient rooms, NYU Langone Health in New York City has been able to use technology to adapt to a new way of delivering care.
During the early phase of the pandemic last spring, the health system quickly scaled up its inpatient virtual health platform leveraging its preexisting technology and operational infrastructure and workflows that were already in place.
“We already had a pretty robust inpatient digital system in place called MyWall that gives patients access to entertainment, educational information and meal ordering with the touch of a button through a wall monitor in their rooms and that’s integrated into Epic (electronic health record system),” Michael Mainiero, senior director of digital strategy and innovation at NYU Langone, told Fierce Healthcare.
The MyWall digital communication tools inside patient rooms at the Kimmel Pavilion and Hassenfeld Children’s Hospital proved to be a vital tool for virtual visits. Working with Oneview Healthcare, the health system is continuing to install MyWall video capabilities across its six inpatient facilities in New York City.
NYU Langone also worked with several technology vendors, including Apple, Oneview Healthcare, Samsung and Cisco, to deploy 1,000 devices across its hospitals.
Oneview, a patient engagement software company, has been working with health systems like NYU Langone to roll out a cloud-based managed tablet solution to enable virtual rounding and virtual visitations.
Clinicians often make hundreds of “rounds” per day to ensure patients are being monitored properly, but, during the pandemic, patient rounding means clinicians are using a lot of personal protective equipment, which is in short supply.
At NYU Langone hospitals, “virtual rounding” enabled providers to communicate with or evaluate their patients without entering the patient’s room to help save PPE, speed up their viewing of a patient and minimize their risk of exposure to COVID-19 while also minimizing their patient’s exposure to other pathogens, Mainiero said.
At a time when hospitalized patients feel isolated due to social distancing protocols and visitor restrictions, NYU Langone also used inpatient video capabilities to connect patients with their loved ones.
The bedside technologies helped connect social workers and care teams to patients to have discussions about goals of care in a way that’s as close to an in-person discussion as possible, Mainiero said.
As the virus surged back in the spring, hospitals confronted the reality that many patients were dying of COVID-19 in ICUs while isolated from their families. For these patients, human interaction often is limited to staff gowned up in full PPE.
“I have heard heart-wrenching stories of patients not being able to speak to their families or cases where nurses were using their own phones and FaceTime to enable patients to speak to their families. This is what people do in a crisis,” said Niall O’Neill, chief product and strategy officer at Oneview Healthcare.
The inpatient video capabilities provide a reliable way to have virtual end-of-life conversations. The aim is to use technology to bring human interaction back into the care setting in support of families, Mainiero said.
Oneview’s COVID-19 solution can be rapidly implemented without any new infrastructure, without on-premise servers and without Oneview staff needing to come on-site, according to O’Neill.
Working with Oneview and other vendors, NYU Langone was able to quickly get devices into clinicians' and patients’ hands at a faster speed than during pre-COVID-19 tech deployments. And the technology was set up without having IT teams moving in and out of patient rooms to help limit exposure to the virus, Mainiero said.
Future of virtual care at the bedside
At NYU Langone, these efforts to scale up virtual care at the bedside during the COVID-19 pandemic have driven the health system to think differently about inpatient virtual care going forward.
Virtual rounding could become standard practice in a post-COVID-19 world as part of medical students’ education, Mainiero said. The platform also enables virtual medical consultations with specialists.
"That’s not novel to the coronavirus. That represents the future of how the inpatient clinical experience is going to be,” he said.
The pandemic has accelerated the use of digital health tools and has demonstrated how virtual care at the bedside can improve efficiencies and maximize access to care, he said.
The faster pace of innovation during the pandemic also will have a ripple effect on healthcare technology, according to O’Neill.
“I think the ability to respond quickly to what’s happening means we will not be stuck in year-long planning cycles or year-long technology release cycles. We can move faster," he said.
"Innovation has been slow in healthcare because nobody wants to break things. Like Facebook founder Mark Zuckerberg's now-famous motto, ‘Move fast and break things.' But now we know through things like automated testing of software, it is possible to move fast," O'Neill said.