Telehealth Comes to the ER

The SBH emergency department has introduced a program that provides
telehealth visits for a limited number of patients who present in the ER with mild COVID-19. These patients, who must have smartphones and Wi-fi at home, leave the ER with a pulse oximeter to measure their oxygen saturation and heart rates following an exam by ER staff. Staff installs the FollowMyHealth app on their phone to allow for subsequent video or telephone follow-up visits.

“We found ourselves in an epicenter of the COVID-19 pandemic, experiencing very high morbidity and mortality in our community,” writes Dr. Jakub Bartnik, ED associate medical director, in a Healthcare Association of New York State (HANYS) members “Spotlight” story. “Both during the spring surge, and the subsequent months we were aware of a cohort of our COVID-19 patients who were able to be discharged from the ED, but whom were at risk of developing hypoxia and clinical deterioration at home.”

The program includes 210 patients to date and has identified 23 patients with “silent hypoxemia as their pulse oximeter readings dip below 92 percent and they don’t yet feel as sick as they are,” adds Dr. Bartnik. “Thankfully, with this program we can catch this and provide them with beneficial therapies such as corticosteroids in the hospital.”

Says Dr. Jeffrey Lazar, vice-chair and medical director of emergency medicine, “It gives patients the feeling that we are literally looking in on them. It seems very supportive of patient satisfaction. Telehealth is the future of medicine, locally, nationally and globally and we want to make sure our communities are not left out.”

Both he and Dr. Bartnik believe telehealth in the ER – as it has throughout the hospital – will evolve in the coming months.

Armed with the knowledge that silent hypoxia and the resultant delay in treatment were significant contributors to morbidity and mortality, and having received a supply of pulse oximeters from NYC’s Office of Emergency Services (not OES), the department was able to develop a robust telehealth follow-up program. By engaging IT, Patient Access and Finance departments, with front line ED staff, a total of 320 pulse oximeters were distributed. Patients have reported high satisfaction with the pilot.