Inpatient Telemedicine Implementation as an Infection Control Response to COVID-19: Qualitative Process Evaluation...

Area of Science:

• Healthcare Technology
• Infectious Disease Management
• Telemedicine

Background:

• The COVID-19 pandemic necessitated rapid adoption of telemedicine to ensure patient and staff safety.
• Understanding effective implementation of inpatient telemedicine for acutely ill patients remains critical.

Purpose of the Study:

• To provide an early example of inpatient telemedicine implementation.
• To evaluate the perceived acceptability and effectiveness of this technology.

Main Methods:

• 15 semistructured interviews with nurses and physicians on a COVID-19 unit.
• Qualitative analysis framed by the RE-AIM framework.
• Identification of key themes through a rapid analytic process.

Main Results:

• Inpatient telemedicine demonstrated wide reach and was perceived effective in reducing COVID-19 exposure and PPE use.
• Physician workflows were stable, but resident education faced challenges; nurses adapted significantly, taking on new duties.
• Patient care quality was maintained, but communication, personal connection, and technical issues were noted challenges.

Conclusions:

• Inpatient telemedicine was acceptable and effective for reducing exposure and PPE use.
• Nurses experienced greater workflow adaptation and burden compared to physicians.
• Recommendations include enhanced IT support, training, functionality, and remote access.