Wound Care During the COVID-19 Pandemic: Improving Outcomes Through the Integration of Telemedicine Alexander Martin 1Donald
1 MS ,
Amit Rao
2 MD ,
and Alisha R. Oropallo
3 MD
and Barbara Zucker School of Medicine at Hofstra/Northwell 2Division of Vascular and Endovascular Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 2Department of Vascular Surgery, Zucker Hofstra School of Medicine, Northwell Health, New York, NY, USA.
Background
Results
• By the end of 2019, an outbreak of pneumonia caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), was identified in Wuhan, China.1, 2 • As of October 16th there are 7.9 million confirmed cases in the US and 216,000 + confirmed deaths.3 • Medical systems relying on face-to-face patient interaction have had to rapidly adapt to protect both patients and providers. • Telemedicine has proven to be one of the most common manifestations of this adaptation in clinical practice today.
Hypothesis Integrating telemedicine into wound care during the outbreak helps practice social distancing, preserve personal protective equipment (PPE) and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk health care providers. To effectively integrate telemedicine, new workflows for providers and patients need to be developed so that providers can quickly adapt to pandemic conditions both for the imminent present and in the future.
Methods
Figure 2: Comprehensive Workflow to determine clerical, clinical, and follow-up processes in office during pandemic or telehealth conditions.
We designed new patient-centered workflows based around integration of Northwell telehealth app and current in- office workflows used at the Northwell Comprehensive Wound Center in Long Island, New York.
Conclusions
Resources 1. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet 2020;395:1054-62. 2. Lu R, Zhao X, Li J, et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet 2020; 395:565-574. 3. Centers for Disease Control and Prevention. CDC COVID Data Tracker, (October 2020). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases
Figure 7: Independent CRISPR knockout of CDK4 or CDK6 does not cause dropout in most breast cancer cell lines studied.
Figure 1: In-Person Workflow to determine patient eligibility for telehealth technology and medical staff duties.
• There is room for transition of previous inperson workflows into hyperflexible telehealth workflows. • This allows for the quick transition of medical offices providing chronic/long-term care to continue to provide services to patients safely during pandemic conditions. • Staff training and workflow orientation will need to take place • Future directions may examine where obstacles to implementation may arise.