Lee Health to employ digital technology to limit COVID-19 exposure in potential surge

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System Director of Virtual Health and Telemedicine at Fort Myers, Fla.-based Lee Health Jonathan Witenko outlines how his health system is becoming a low-contact facility and the strategy to prepare for another surge of COVID-19 patients later this year.

Question: What technology are you implementing or considering that will make workflows and interactions "contactless" for patient and staff safety?

Jonathan Witenko: For our ambulatory facilities, we are an Epic-based organization and we have had an Epic workflow for video visits for over two years. However the backbone technology has matured to the point of approaching sunset of support. We had planned in this year's budget to update to 'Web RTC.' This is a newer technology that downplays the interactions between applications and websites. We have accelerated and implemented this technology. Lee Physician Group is almost fully deployed for video visit performance. We plan to work to understand what patients would be best for virtual or in person visits and how to relay that information to our patients.

For our acute care facilities and skilled nursing facilities, we have expanded the number of telemedicine carts from a few per building to multiple per unit. We've opened up access for both our employed physicians and community physicians to perform consultations from dedicated locations both within the facility (multidisciplinary rounding) and remotely (computers and smart devices). Many of these carts have been outfitted with digital stethoscopes and derm cameras allowing auscultation and wound checks to be done remotely.

For patients in our acute care facilities, we've armed guest services and clinical staff with iPads provisioned with a secure video conferencing application. This allows patients without a smart device the ability to interact with loved ones by sending them a link they can open on any device (WebRTC).

For registration in our EDs and Convenient Care locations, we've set up telemedicine carts to virtually connect a patient and provider to ensure they are appropriately triaged prior to entering the facility.

For our NICU, we’ve set up a telemedicine connection in each baby's room and enable parents to see their son/daughter from their computer or smart device (WebRTC).

Q: How are you planning for a potential second surge of COVID-19 patients later this year? What should hospitals think about from the IT perspective?

JW: We are continuing to implement our telehealth strategy through several projects. Some of them will improve 'contactless' engagements. They include:

1. Virtual Patient Observation: During an inpatient admission, we will be able to virtually observe and interact with a patient in a bed. This will improve patient satisfaction as well as decrease the staff physical interaction and hence COVID exposure.

2. Remote Patient Monitoring. This is a large project and we are currently discussing what parts or pieces could be explored first. Examples include virtual home care management, COVID symptom tracking and vital sign integration.

3. Hospitals should reevaluate their data center capacities. Most of these newer technologies are cloud based but do have some storage and security implications.

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