The Use of Telehealth Tools to Enhance Infection Controls March 30, - PowerPoint PPT Presentation

The Use of Telehealth Tools to Enhance Infection Controls March 30, 2015

Disclosures None.

OHSU Overview Hospital Summary Located in Portland, Oregon 576 Beds 2861 Students

OHSU Overview IT Infrastructure 72,000 Networked Devices 2,460 Wireless Access Points 492 Physical Servers 1,796 Virtual Servers 17,000 Networked Computers (Data Center West) 3,000 Networked Printers 14,000 Telephones 30,000 E-mail Accounts 2,843 Databases 3 Petabytes Storage 2 Data Centers 125 Buildings & 5,640,000 Square Feet Serviced

OHSU Overview Telehealth Program began 2007 27 Sites Service Lines Stroke, PICU, NICU, Genetics, Trauma, Neurosx, Psychiatry In-Home Care

Telehealth Engineering Innovation through Improvisation Know your toolbox Adapt known technologies Focus on interoperability and scalability

August 2014 Infected Ebola Caregivers Arrive in US for Treatment Treatment conducted at established centers Hospitals educate IC/Hygiene best practices Occurs in a detached reality media bubble

October 2014 The Bubble Breaks First US cases diagnosed Media panic ensues Hospitals now on Ebola-watch Infection Control protocols are re-evaluated Additional resources sought

Infection Control IT Resources Evaluation Telehealth for enhanced communications? Device selection Protection and decontamination Footprint in EB space

Infection Control The Unit Designated on-call “EB” space Reverse pressure room in the MICU Limited space Nearby team room

Infection Control Existing Tools Physical barriers Clumsy at times Truly Analog

Infection Control The Telehealth Toolbox Communications (Clinical and Family) Diagnostic Imaging Patient Monitoring

Infection Control Non-Telemedicine IT Tools Wireless monitoring Mobile Apps Degowning robots HUD/”Glass” tools to bring screens inside PPE

EB Drills at OHSU Drills were primarily for staff readiness Telemedicine tools placed on-site

EB Drills at OHSU Telemedicine Tools Intouch RPLite Avizia CA700 3M Littmann Stethoscope “EB” Laptop

EB Drills at OHSU Findings Quick deployment Technology was intimidating at first Ad Hoc clinical presence Off-Site intervention options

Hospital Preparedness Outfitting Units Define Clean and Contaminated Spaces Pre-set Key Infrastructure Validate Network Connectivity Familiarize Tech Teams with Location Define the workflow

Hospital Preparedness Clean Team Deployment Define the storage location and access Preconfigure existing infrastructure Compile complete equipment inventory On-site staffing of the tools

Hospital Preparedness Contamination Team Deployment Define the storage location and inventory Preconfigure and test when possible Equipment positioning in space Know diagnostic equipment connections PPE training for IT staff

No Ebola in Portland But… The EB scenario proved an effective setting to develop Telehealth and IT based infection control tools.

Findings Takeaway #1 Decide on the importance of preserving the IT tools Know what is expendable

Findings Takeaway #2 Normal IT rules can be broken (within reason) Scalability and Interoperability not important Consumer IT tools should be considered

Findings Takeaway #3 Know your on-site diagnostic connectivity Itemize necessary cabling

Findings Takeaway #4 Develop a set of IT “Go-Bags” Clean Room Kit Contaminated Room Kit • Bluetooth receiver for stethoscope • Bluetooth stethoscopes • Cheap tablet preloaded to access • Cheap tablet preloaded to access medical records, EPI Info software medical records, EPI Info software from CDC, stream doffing and from CDC, stream doffing and gowning videos gowning videos • Teleconferencing receiving equipment • Wearable device for video streaming • Written instructions on how to receive • Wireless pulse oximeter, heartrate and the wireless medical device readings blood pressure cuff

Conclusions Telemedicine tools are an excellent complement to infection control protocols The experience informed hospital administration of the value of these tools for infection control

Collaborators Kyle Hall Telehealth Coordinator Nebraska Medical Center Rachel James Security Engineer Oregon Health & Science University

Questions or Comments? Thank You!