Solving Community SARS-CoV-2 Testing With Telehealth: Development and Implementation for Screening, Evaluation and Testing.

Aditi U Joshi,Maria Aini,Bracken Babula,Resa E Lewiss,Patricia C Henwood

doi:10.2196/20419

Aditi U Joshi, Maria Aini + Show 3 more

Open Access

https://doi.org/10.2196/20419

Copy DOI

Abstract

BackgroundTelehealth has emerged as a crucial component of the SARS-CoV-2 pandemic emergency response. Simply stated, telehealth is a tool to provide health care from a distance. Jefferson Health has leveraged its acute care telehealth platform to screen, order testing, and manage patients with COVID-19–related concerns.ObjectiveThis study aims to describe the expansion and results of using a telehealth program to increase access to care while minimizing additional potential exposures during the early period of the COVID-19 pandemic.MethodsScreening algorithms for patients with SARS-CoV-2–related complaints were created, and 150 new clinicians were trained within 72 hours to address increased patient demand. Simultaneously, Jefferson Health created mobile testing sites throughout eastern Pennsylvania and the southern New Jersey region. Visit volume, the number of SARS-CoV-2 tests ordered, and the number of positive tests were evaluated, and the volume was compared with preceding time periods.ResultsFrom March 8, 2020, to April 11, 2020, 4663 patients were screened using telehealth, representing a surge in visit volume. There were 1521 patients sent to mobile testing sites, and they received a telephone call from a centralized call center for results. Of the patients who were tested, nearly 20% (n=301) had a positive result.ConclusionsOur model demonstrates how using telehealth for a referral to central testing sites can increase access to community-based care, decrease clinician exposure, and minimize the demand for personal protective equipment. The scaling of this innovation may allow health care systems to focus on preparing for and delivering hospital-based care needs.

Highlights

The SARS-CoV-2 (COVID-19) pandemic presented the need to rapidly evolve the traditional in-person care model to distance treatment
A team composed of infectious disease specialists, health system clinical leadership, and occupational medicine leadership created screening protocols to determine who should be tested from the community, which groups of employees should be tested if they first contacted JeffConnect, and who could stay at home with guidance on self-isolation
Initial screening protocol developed during implementation considered limited testing capacity and prioritized COVID-19 infections in patients who presented with fever or symptoms of acute respiratory illness, were at the highest risk of exposure, were at a higher risk of developing severe disease, or were at a high risk of exposing others

Summary

Introduction

The SARS-CoV-2 (COVID-19) pandemic presented the need to rapidly evolve the traditional in-person care model to distance treatment. Due to the current pandemic, telehealth has been quickly leveraged to safely keep people at home, disseminate information, allow decisions around testing to be made, coordinate testing when appropriate, and risk stratify patients for evidence-based and resource efficient care. In the time of COVID-19, the benefit of telehealth seems obvious: a patient can be seen remotely, assessed, and evaluated for need of testing, all without a visit to the doctor’s office or to the emergency department (ED). Jefferson Health has leveraged its acute care telehealth platform to screen, order testing, and manage patients with COVID-19–related concerns

Methods

Results

Discussion

Conclusion