COVID-19: Alexa and iPads help reduce personal contact in hospitals & save PPE

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COVID-19: Alexa and iPads help reduce
personal contact in hospitals & save PPE

During the peak of the first wave of COVID infections in the spring of 2020, face masks, disposable gloves, and protective clothing were scarce commodities – even in the USA. As a result, Yale New Haven Health System and the Yale School of Medicine decided to make increased use of TeleHealth tools to reduce direct contact with patients and ultimately use less personal protective equipment (PPE). In the journal “Applied Clinical Informatics” (Thieme, New York. 2020), informatics experts at the US hospital system explain that the simultaneous use of monitors, tablets, smartphones, and Echo and Alexa devices reduced contact between employees and patients, which impeded the spread of the virus among hospital staff.

The COVID-19 pandemic in the spring of 2020 lead to a worldwide shortage of personal protective clothing and equipment. Even hospital systems with adequate financial resources – like the Yale New Haven Health System – were unable to order enough face masks, disposable gloves, or protective clothing. At the same time, at the peak 786 COVID-19 patients were concurrently admitted across the hospital association’s seven facilities. They needed to be cared for, while the staff and remaining patients needed to be protected from infection.

To limit contact with patients to a minimum, the hospital system decided to increase the use of tele health devices. Within a few weeks, more than 1,800 monitors, iPads, iPhones, Echo devices, Fire tablets, and baby monitors had been purchased. They made it possible to communicate with patients without having to meet in person, which, in turn, reduced the demand for required PPE.

The conclusion drawn from the real-world experiment by medical informatics officer Allen Hsiao is very positive. Staff on intensive care units (ICU), in operating theatres, emergency rooms, recovery rooms and on wards can communicate via monitors, meaning that personal contact between them is reduced. This has also made it possible to minimize the number of providers visiting a patient’s room, e.g. as part of rounds. Conversely, staff caring for patients at the sites were able to view patient files and see test results without having to leave the room and change protective clothing.

Voice-controlled Echo and Alexa devices were also used and turned out to be particularly useful in emergency rooms and ICUs because staff could use them without having to touch them. That meant both hands were free in an emergency, for example to prevent a patient from removing the tube from their ventilator as clinicians could simultaneously request help using voice commands. ICU nurses, who needed to remain at the bedside for prolonged periods of time to care for the most critically ill patients, used the devices to communicate with their colleagues outside the room. The iPads were primarily used for communicating with patients, which reduced the number of visits to patients’ rooms and also facilitated physicians to be able to discuss life-sustaining measures with relatives who were not allowed to enter the hospital for infection control reasons. Doctors and nurses were also able to use the newly-bought iPhones to securely communicate with each other as the text messages could be encrypted before being sent.

Hsiao is convinced that it could be sensible to continue using the devices after the pandemic. Mobile monitor trolleys can be quickly and individually adapted according to the situation and placed in any location. The devices could also be used for contacting patients in the future, thus saving them long trips to hospital. Also, tablets can be used for providing information to patients, and Hsiao is certain that voice-controlled devices in emergency rooms and ICUs would improve treatment effectiveness and safety in the future too.

Ref: S. Y. Ong, L. Stump, M. Zawalich, L. Edwards, G. Stanton, M. Matthews, A. L. Hsiao:
Inpatient TeleHealth Tools to Enhance Communication and Decrease Personal Protective Equipment Consumption during Disaster Situations: A Case Study during the COVID-19 Pandemic Applied Clinical Informatics 2020; 5 (11); p. 733–741. DOI: 10.1055/s-0040-1719180

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