Telehealth and Medicine Today

Deployment of Artificial Intelligence in Neuro Critical Care

Krishnan Ganapathy — 2024-06-30

First Do No Harm: The Impact of Telemedicine on Health Disparities

Elizabeth Baker — 2024-06-29

Building Comfort and Success at Failing

Sarah B. Harper, MA, MBA — 2024-06-29

Failing is an important issue for businesses. Embracing it moves markets, insures consumer safety, and spares unnecessary investment. Are the aviation and nuclear power industries the only industries to truly embrace it and share learnings to fortify standards and best practices? Can healthcare do the same?

Telehealth and Medicine Today (THMT) is pleased to spotlight the critical necessity to face failure personally and professionally. Do we place too much emphasis on failure avoidance vs. failure recovery? Risk management hallmarks prioritize protecting the “brand” over sharing the experience.

What are the principles for succeeding at failure? What models can we use? How does this impact burnout, workforce turnover, leadership vulnerability, and conducting meaningful retrospectives? Join our distinguished speakers representing health system, research community, and enterprise in this thoughtful and reflective discussion.

THMT would like to continue discussions on this pivotal theme with experts in the field. Reach out to offer your learnings by emailing info@partnersiindigitalhealth.com. Alternatively, submit your research, opinion, or perspective to the journal here.

Resources

Episode 564: How to Succeed at Failing, Part 4: Extreme Resiliency, Theresa MacPhail, Stevens Institute of Technology, https://freakonomics.com/podcast/how-to-succeed-at-failing-part-4-extreme-resiliency/
Illuminating ‘the ugly side of science’: fresh incentives for reporting negative results, https://www.nature.com/articles/d41586-024-01389-7
Open Access Publisher Responds to White House with NO APC for Negative Research
Management Lessons from Mayo Clinic: Inside One of the World's Most Admired Service Organizations
Haru Urara: Japan’s Lovable Loser
Trust in Radical Truth and Radical Transparency, Ray Dalio
What Is Psychological Safety?, HBR
Museum of Failure
The Daily Stoic
Humble Inquiry, Edgar Shien
The Power of Regret, Daniel Pink
Watch Bad Surgeon: Love Under the Knife, Netflix
The Bizarre Story of ‘Vasa,’ the Ship That Keeps On Giving https://www.smithsonianmag.com/smart-news/bizarre-story-vasa-ship-keeps-giving-180964328/
The History of Fika: Swedish Coffee Break, https://food52.com/blog/9499-the-history-of-fika-swedish-coffee-break

Standardizing Competencies and Enhancing Professionalism Through a Telepresenter Certificate Program

Rita Kobb — 2024-06-29

Background: Telehealth researchers frequently identify barriers to telehealth delivery, but often their literature does not propose change management strategies to improve access to care through telehealth. Systematic reviews support findings that education and training are lacking to ensure high-quality telehealth delivery. Curriculum that addresses technical skills, provides a clinical perspective for addressing digital health care, and proposes best practices can build the foundation for a competent telehealth workforce — most crucially, telepresenters.

Objective: Recognizing an unmet need for standardized training for telepresenting health care professionals, the U.S. Department of Veterans Affairs’ Office of Connected Care (VA OCC) built on its prior telehealth experience to create a Telepresenter Certificate Program (TCP) in partnership with the University of Florida College of Nursing (UF CON). This paper describes the program’s curriculum, the educational methods used, and learners’ responses to a summative survey that evaluated the TCP’s impact.

Methods: VA OCC and UF CON created a curriculum encompassing two courses. The first course was an introduction to the current knowledge regarding digital health, including the role of clinical informatics, electronic health records, patient-generated health data, and trends in data use in health care. The second course helped learners understand required telehealth competencies through patient case scenarios and covered topics such as how to telepresent virtual medical exams and apply these skills in practice.

Results: Over a total of four TCP cohorts, 909 learners completed the program. Among overall learners, 87% agreed or strongly agreed that “they will be able to apply the knowledge and skills learned to effectively assist telehealth providers in delivering patient care using telehealth technology.” On average, 94% of TCP completers were satisfied with the program.

Discussion: VA OCC’s partnership with UF CON successfully created a novel curriculum to standardize competencies and enhance professionalism for the telepresenter role through the TCP. Learners positively endorsed their acquisition of skills and their satisfaction with the program. The TCP offers a viable model for other health care consortiums to standardize competencies and enhance professionalism for telepresenters, resulting in improved telehealth quality and increased health care access.

Avoiding ICU Admission in a Case of Septic Encephalopathy Through Enhanced Connected Care Monitoring: A Case Study

Hima Bindu Kotamarthy — 2024-06-29

Aim: To report a case of an elderly patient with septic encephalopathy admitted in the wards. With the help of enhanced connected care monitoring, ICU admission was avoided.

Materials and Methods: An 81-year-old gentleman who is a known diabetic & hypertensive presented to the Emergency room with complaints of generalized weakness of bilateral upper & lower limbs and a recent history of acute gastroenteritis. The patient was evaluated and admitted to wards for further management. On examination, the patient is drowsy and arousable on call and hemodynamically stable. Stool biofire was sent, which was positive for Ecoli Shiga-toxin. A provisional diagnosis of septic encephalopathy was made. Because of background conditions and multiple issues, the patient was connected to Enhanced Care Monitoring (ECC). The patient was constantly monitored by a nurse and doctor from the command center. Three days after admission, the patient had an alert for desaturation with a low saturation of 74%, and immediately nursing staff was informed by the command center team. Shortly 2 hours later, one more critical alert was generated for Tachycardia HR 178/min. The nursing staff was informed by the command center team. Immediately bedside vitals were rechecked, and the doctor was informed, and the patient improved symptomatically with the management of sepsis and was discharged home.

Discussion: Remote patient monitoring can track vital signs, identify deteriorating patterns at an early stage, and alert healthcare staff, reducing ICU admissions. This is illustrated in an elderly patient with septic encephalopathy, where continuous wireless monitoring enabled avoiding ICU admission. Enhanced care monitoring was done through wearable biosensors. Vital data obtained helped identify potential emergencies. Appropriate real-time responses avoided an ICU admission.

Conclusion: Wearable and implanted sensors efficiently monitor elderly patients in wards without hindering mobility. The term "immediately" might be misleading, but it's crucial to emphasize that within two hours of observing consecutive signs of deterioration in the patient, swift action was taken. Addressing these concerning signs promptly prevented the need for the patient's transfer to the ICU, showcasing successful management within the ward setting.