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November 19, 2014 Readers Write No Comments

Leveraging Technology for Communicable Disease Care
By Paul J. Caracciolo


The Ebola crisis has been another wake-up call for healthcare providers to get prepared for national and global medical emergencies. Experts agree that it is only a matter of time before the world experiences another pandemic, such as the flu of 1918 that killed many of millions worldwide.

The recent outbreak of Ebola in West Africa and subsequent spread to the US has caused providers to re-examine how they handle sick (and potentially infected) patients, but we don’t have to use Ebola as the example. The seasonal flu still has a significant impact on health and many deaths occur each year. This past year has also seen the rise of enterovirus D68, sickening many hundreds of children across the country, resulting in several deaths.

The proper care of patients with communicable disease is a concern. We want to ensure that patients receive appropriate care, but at the same time, we need to take precautions around the containment and spread of disease. Recently, CNN News reported statistics that approximately 4.5 percent of reported Ebola cases in West Africa are infected caregivers. In the case of Ebola, disease management is further complicated considering the 21-day incubation period, with possible imposed isolation and continuous monitoring of potentially infected patients during this time.

Solutions can be implemented now that could make a huge difference in not only increasing the quality of patient care, but also protecting caregivers from prolonged or unnecessary exposure to sick patients.

Telehealth / telemedicine. It would be beneficial to have this capability in sick patient rooms to control access. This would allow remote consults with disease specialists, primary care providers, ancillaries, or whoever needs direct access to these patients and their caregivers. This solution could be expanded to include two-way audio and video with nursing staff and HD video conferencing between the patient and their families. Or in the case of isolation for potential infection, patients could communicate with their loved ones, employers, benefits providers, or anyone else on the outside.

Virtual patient observation. This solution includes video equipment, network integration with nurse call, and intelligent software that can be configured to be sensitive to patient movement. A monitoring console can be presented at a nurse station computer or accessed mobile from tablets. Several patients can be monitored from one station, or select rooms can be monitored. Coupled with two-way voice communication, this can be a powerful tool.

Alert and alarm management, workflow enhancement. This middleware that can capture relevant patient data from monitoring devices and lab results and then present this data to caregivers on mobile devices. Staying with the theme of patient and caregiver safety and more efficient workflows, this technology can streamline communications. Alarms from biomedical equipment in a patient’s room can be triaged by the configured system, thus preventing alarm fatigue for caregivers and focusing attention on critical alarms. Additionally, these applications can use push notification technology to send out critical lab test results, with related information, to the mobile devices of clinicians Secure text messaging, typically another feature, can streamline communications and record the information and send it to the EMR to complete the care record and maintain compliance.

Care team collaboration applications. Having the ability to share patient related data is key to keeping care teams on the same page. Access to the EMR may not be feasible for all caregivers involved. The ability to share documents, notes, lab results, and images (and imaging) among care team members wherever they may be is powerful. Even caregivers who are suspected of being infected (and in isolation) could still be part of a productive care team with these applications. Cloud applications could be used on demand and are easily scalable to fit emergency scenarios.

Hospitals can take action now to be better prepared to deal with outbreaks. Although many hospitals may not have formal isolation rooms, they may want to designate and prepare certain rooms that could be used in a more formal manner if needed in emergencies. For instance, specific nurse wards, floors, or group of rooms could be outfitted with these technologies. In time of emergency, the emergency protocol would kick in, with technology in place and workforce trained. These technologies can also be used on demand for triage or isolation tents, with portable versions of telemedicine and virtual patient observation solutions.

Paul J. Caracciolo is chief healthcare officer of Nexus – A Dimension Data Company of Valencia, CA.

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