Virtual Remote Attending Supervision in an Academic Emergency Department During the COVID-19 Pandemic.

Abstract

Background: As the surge of patients with COVID-19 increased, our academic university faculty needed to explore ways to protect the more vulnerable physicians in the group from infection while maintaining the service to our patients and the educational objectives of our residency training program. Methods: We utilized telehealth carts used for other purposes in the institution and the ED to allow the replacement of one physically present supervising attending physician with a virtual remote attending physician. This physician, working from home, can be virtually present for resident history and physicals with all patients in the supervised pod. Discussions about patient care, review of studies, and decision on final disposition can also be performed. Resident teaching can also be accomplished. Results: Our innovation represents a novel use of telemedicine capabilities which allows us to protect vulnerable faculty from infection during the COVID-19 pandemic while maintaining appropriate EM resident supervision and patient care. We found some advantages of this process which allow us to more directly observe the initial resident assessment of the patient. The residents responded favorably to the degree of supervision and patient care that we can provide remotely. Conclusions: Our novel use telemedicine during the COVID-19 pandemic has allowed us to decrease the exposure of more vulnerable faculty while maintaining the ability of these faculty to continue to contribute to patient care and resident education. It is well accepted by our residents and seems to be a viable alternative to physical presence in the ED for at least one faculty member. This modality might also be utilized by an attending who fell ill and was not yet able to return to physical work. We hope our description of this process might be useful to other academic departments or community hospital groups who may have at-risk members.