Unclassified//For Public Use TRACIE HEALTHCARE EMERGENCY PREPAREDNESS INFORMATION GATEWAY ASPR ASSISTANT SECRETARY ~- OR PREPAREDNESS AND RESPONSE Use of Telemedicine in Alternate Care Sites July 28, 2020 Unclassified//For Public Use Access the recorded webinar here: https://attendee.gotowebinar.com/ recording/3569767218279856910 Access speaker bios here: https:// files.asprtracie.hhs.gov/documents/telemedicine-in-alternate-care- sites-speaker-bios.pdf Access Q&A here: https://files.asprtracie.hhs.gov/documents/aspr- tracie-ta-telemedicine-in-alternate-care-sites-qa---final.pdf
30
Embed
Use of Telemedicine in Alternate Care Sites · ter Virtual care: new models of caring for our patients and workforce am@ CronMut. The coronavirus disease 2019 (COVID-19) pandemic
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Use of Telemedicine in Alternate Care Sites
July 28 2020
UnclassifiedFor Public Use
Access the recorded webinar here httpsattendeegotowebinarcomrecording3569767218279856910
Access speaker bios here httpsfilesasprtraciehhsgovdocumentstelemedicine-in-alternate-care-sites-speaker-biospdf
Access QampA here httpsfilesasprtraciehhsgovdocumentsaspr-tracie-ta-telemedicine-in-alternate-care-sites-qa---finalpdf
UnclassifiedFor Public Use
llirL TECHNICAL IIPr RESOURCE$
__II_ ASS ISTANCE CENTER
J ~ INFORMATION ~ EXCHANGE
asprtraciehhsgov
1-844-5-TRACIE
askasprtraciehhsgov
ASPR AUIS1ANT bulllCUTtamp~ ~00
UIPAUDgt1111 ~gtIC UfPO~H HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~
I NfORMAT IONGAIEWAf
ASPR TRACIE Three Domains
bull Self-service collection of audience-tailored materials
bull Subject-specific SME-reviewed ldquoTopic Collectionsrdquo bull Unpublished and SME peer-reviewed materials
highlighting real-life tools and experiences
bull Personalized support and responses to requests forinformation and technical assistance
bull Accessible by toll-free number (1844-5-TRACIE)email (askasprtraciehhsgov) or web form (ASPRtraciehhsgov)
bull Area for password-protected discussion amongvetted users in near real-time
bull Ability to support chats and the peer-to-peerexchange of user-developed templates plans andother materials
2
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Resources bull ASPR TRACIE COVID-19 Page ndash COVID-19 TelemedicineVirtual Medical Care Resources ndash COVID-19 and Telehealth Quick Sheet
Denis FitzGerald MD Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Alternate Care Site Framework
bull Broad term for any building or structure of opportunity converted for healthcare use that provides additional healthcare capacity (eg beds) and capability (eg ventilators) for an affected community outside the walls of a traditional established healthcare institution
bull Serves various patient types (eg COVID-19 or non-COVID-19) and purposes (eg non-acute hybrid or acute care)
bull Established in many types of buildings (eg hotel or arena)
6
UnclassifiedFor Public Use
roduct Purpose
Federal Healthcare Resilience Task Force
Alternate Care Site Toolkit
Third Edition
This Alternate Care Site ACS) Toolkit is medical operations guidance and was developed to help state local tribal and territorial (SL TT) entities address potential capacity and capabil ity 9aps in healthcare systems durin9 the 2020 SARS-CoV-2 virus (COVI0-19) pandemic It is intended to provide medical operations guidance and technical assistance to SL TT entities in establishing and operationalizing an ACS used to care for COVID-19-positive or presumed positive patients If an ACS is used to treat non-COVID-19 patients additional considerations will apply
Intended Audience State Local Tribal and Territorial Entities FEMA Regional Administrators HHS Regional Administrators Healthcare Systems
ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Alternate Care Site Toolkit bull Best practices reference to
support state local tribaland territorial entities in establishing and operationalizing ACSs
bull Provides ldquoone goodapproachrdquo that can beleveraged in total or in part
7
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Til Jolly MD FACEP Aveshka supporting HHSASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Denis FitzGerald MD Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Alternate Care Site Framework
bull Broad term for any building or structure of opportunity converted for healthcare use that provides additional healthcare capacity (eg beds) and capability (eg ventilators) for an affected community outside the walls of a traditional established healthcare institution
bull Serves various patient types (eg COVID-19 or non-COVID-19) and purposes (eg non-acute hybrid or acute care)
bull Established in many types of buildings (eg hotel or arena)
6
UnclassifiedFor Public Use
roduct Purpose
Federal Healthcare Resilience Task Force
Alternate Care Site Toolkit
Third Edition
This Alternate Care Site ACS) Toolkit is medical operations guidance and was developed to help state local tribal and territorial (SL TT) entities address potential capacity and capabil ity 9aps in healthcare systems durin9 the 2020 SARS-CoV-2 virus (COVI0-19) pandemic It is intended to provide medical operations guidance and technical assistance to SL TT entities in establishing and operationalizing an ACS used to care for COVID-19-positive or presumed positive patients If an ACS is used to treat non-COVID-19 patients additional considerations will apply
Intended Audience State Local Tribal and Territorial Entities FEMA Regional Administrators HHS Regional Administrators Healthcare Systems
ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Alternate Care Site Toolkit bull Best practices reference to
support state local tribaland territorial entities in establishing and operationalizing ACSs
bull Provides ldquoone goodapproachrdquo that can beleveraged in total or in part
7
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Til Jolly MD FACEP Aveshka supporting HHSASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Denis FitzGerald MD Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Alternate Care Site Framework
bull Broad term for any building or structure of opportunity converted for healthcare use that provides additional healthcare capacity (eg beds) and capability (eg ventilators) for an affected community outside the walls of a traditional established healthcare institution
bull Serves various patient types (eg COVID-19 or non-COVID-19) and purposes (eg non-acute hybrid or acute care)
bull Established in many types of buildings (eg hotel or arena)
6
UnclassifiedFor Public Use
roduct Purpose
Federal Healthcare Resilience Task Force
Alternate Care Site Toolkit
Third Edition
This Alternate Care Site ACS) Toolkit is medical operations guidance and was developed to help state local tribal and territorial (SL TT) entities address potential capacity and capabil ity 9aps in healthcare systems durin9 the 2020 SARS-CoV-2 virus (COVI0-19) pandemic It is intended to provide medical operations guidance and technical assistance to SL TT entities in establishing and operationalizing an ACS used to care for COVID-19-positive or presumed positive patients If an ACS is used to treat non-COVID-19 patients additional considerations will apply
Intended Audience State Local Tribal and Territorial Entities FEMA Regional Administrators HHS Regional Administrators Healthcare Systems
ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Alternate Care Site Toolkit bull Best practices reference to
support state local tribaland territorial entities in establishing and operationalizing ACSs
bull Provides ldquoone goodapproachrdquo that can beleveraged in total or in part
7
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Til Jolly MD FACEP Aveshka supporting HHSASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Moderator- Meghan Treber MS ASPR TRACIE
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Denis FitzGerald MD Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Alternate Care Site Framework
bull Broad term for any building or structure of opportunity converted for healthcare use that provides additional healthcare capacity (eg beds) and capability (eg ventilators) for an affected community outside the walls of a traditional established healthcare institution
bull Serves various patient types (eg COVID-19 or non-COVID-19) and purposes (eg non-acute hybrid or acute care)
bull Established in many types of buildings (eg hotel or arena)
6
UnclassifiedFor Public Use
roduct Purpose
Federal Healthcare Resilience Task Force
Alternate Care Site Toolkit
Third Edition
This Alternate Care Site ACS) Toolkit is medical operations guidance and was developed to help state local tribal and territorial (SL TT) entities address potential capacity and capabil ity 9aps in healthcare systems durin9 the 2020 SARS-CoV-2 virus (COVI0-19) pandemic It is intended to provide medical operations guidance and technical assistance to SL TT entities in establishing and operationalizing an ACS used to care for COVID-19-positive or presumed positive patients If an ACS is used to treat non-COVID-19 patients additional considerations will apply
Intended Audience State Local Tribal and Territorial Entities FEMA Regional Administrators HHS Regional Administrators Healthcare Systems
ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Alternate Care Site Toolkit bull Best practices reference to
support state local tribaland territorial entities in establishing and operationalizing ACSs
bull Provides ldquoone goodapproachrdquo that can beleveraged in total or in part
7
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Til Jolly MD FACEP Aveshka supporting HHSASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Denis FitzGerald MD Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Alternate Care Site Framework
bull Broad term for any building or structure of opportunity converted for healthcare use that provides additional healthcare capacity (eg beds) and capability (eg ventilators) for an affected community outside the walls of a traditional established healthcare institution
bull Serves various patient types (eg COVID-19 or non-COVID-19) and purposes (eg non-acute hybrid or acute care)
bull Established in many types of buildings (eg hotel or arena)
6
UnclassifiedFor Public Use
roduct Purpose
Federal Healthcare Resilience Task Force
Alternate Care Site Toolkit
Third Edition
This Alternate Care Site ACS) Toolkit is medical operations guidance and was developed to help state local tribal and territorial (SL TT) entities address potential capacity and capabil ity 9aps in healthcare systems durin9 the 2020 SARS-CoV-2 virus (COVI0-19) pandemic It is intended to provide medical operations guidance and technical assistance to SL TT entities in establishing and operationalizing an ACS used to care for COVID-19-positive or presumed positive patients If an ACS is used to treat non-COVID-19 patients additional considerations will apply
Intended Audience State Local Tribal and Territorial Entities FEMA Regional Administrators HHS Regional Administrators Healthcare Systems
ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Alternate Care Site Toolkit bull Best practices reference to
support state local tribaland territorial entities in establishing and operationalizing ACSs
bull Provides ldquoone goodapproachrdquo that can beleveraged in total or in part
7
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Til Jolly MD FACEP Aveshka supporting HHSASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Alternate Care Site Framework
bull Broad term for any building or structure of opportunity converted for healthcare use that provides additional healthcare capacity (eg beds) and capability (eg ventilators) for an affected community outside the walls of a traditional established healthcare institution
bull Serves various patient types (eg COVID-19 or non-COVID-19) and purposes (eg non-acute hybrid or acute care)
bull Established in many types of buildings (eg hotel or arena)
6
UnclassifiedFor Public Use
roduct Purpose
Federal Healthcare Resilience Task Force
Alternate Care Site Toolkit
Third Edition
This Alternate Care Site ACS) Toolkit is medical operations guidance and was developed to help state local tribal and territorial (SL TT) entities address potential capacity and capabil ity 9aps in healthcare systems durin9 the 2020 SARS-CoV-2 virus (COVI0-19) pandemic It is intended to provide medical operations guidance and technical assistance to SL TT entities in establishing and operationalizing an ACS used to care for COVID-19-positive or presumed positive patients If an ACS is used to treat non-COVID-19 patients additional considerations will apply
Intended Audience State Local Tribal and Territorial Entities FEMA Regional Administrators HHS Regional Administrators Healthcare Systems
ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Alternate Care Site Toolkit bull Best practices reference to
support state local tribaland territorial entities in establishing and operationalizing ACSs
bull Provides ldquoone goodapproachrdquo that can beleveraged in total or in part
7
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Til Jolly MD FACEP Aveshka supporting HHSASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use
roduct Purpose
Federal Healthcare Resilience Task Force
Alternate Care Site Toolkit
Third Edition
This Alternate Care Site ACS) Toolkit is medical operations guidance and was developed to help state local tribal and territorial (SL TT) entities address potential capacity and capabil ity 9aps in healthcare systems durin9 the 2020 SARS-CoV-2 virus (COVI0-19) pandemic It is intended to provide medical operations guidance and technical assistance to SL TT entities in establishing and operationalizing an ACS used to care for COVID-19-positive or presumed positive patients If an ACS is used to treat non-COVID-19 patients additional considerations will apply
Intended Audience State Local Tribal and Territorial Entities FEMA Regional Administrators HHS Regional Administrators Healthcare Systems
ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Alternate Care Site Toolkit bull Best practices reference to
support state local tribaland territorial entities in establishing and operationalizing ACSs
bull Provides ldquoone goodapproachrdquo that can beleveraged in total or in part
7
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Til Jolly MD FACEP Aveshka supporting HHSASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Til Jolly MD FACEP Aveshka supporting HHSASPR
UnclassifiedFor Public Use
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Paul D Biddinger MD FACEP Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital
UnclassifiedFor Public Use
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
Virtual care new models of caring for our patients and
workforce
am CronMut
The coronavirus d isease 2019 (COVID-19) pandemic
has accelerated the widespread adoption of
collaborat ion and communication software to enable
medical care at a distance and reduce the risk of
tra nsmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) between pat ient s and
hea lth-ca re providers from gat hering toget her in
hospitals offices or clin ics Most virtual ca re solut ions
have been implemented to ensure adequate phys ical
ampi1 MASSCH USEITS V GE ERALHOSPITAL
- ToLEHEALTH
D MASSA HUSETTS 9 GENERAL HOSPITAL
CE ITER FOR DISASTER MEDICINE
and give suggestions for how t hese innovat ions might
be implemented at ot her institutions
Maintaining an adequate supply of healt h-care
workers is vital to reducing mortal ity due to COV ID-19
Many health-care systems have st rugg led to preseive
members of the workforce after community spread
has begun At our hospital (Massachusetts General
Hospital Boston MA USA) at t he st art of the epidemic
healt h-ca re workers who were exposed to COVID-19
Lanm DJgltal Heclth 2020
Pub lished Online May 6 2020
httpsJ doiorgl 101016 51589 -7 500( 20)30104-7
npj I Digital Medicine wwwnaturecomnpjdig italmed
PERSPECTIVE OPEN ~11) Chockfoupdatcj
A digital embrace to blunt the curve of COVID 19 pandemic Lee H Schwamm E)11235B Ali stair Erskine e1 25 and Adam Licursel 245
Digital health virtua l care telehealth and telemedicine are all terms often used interchangeably to refer to the practice of care delivered from a distance Because virtual care collapses the barriers of time and distance it is ideal for providing care that is patient-centered lower cost more conven ient and at greater productivity All these factors make virtual care tool s indispensable elements in the COVID19 response In this perspective we offer implementation guidance and policy insights relevant to the use of virtual care tool s to meet the challenges of the COVID19 pandemic
npj Digital Medicine (2020) 364 https doiorg1 01 03 8 s417 46-020-02 79-6
Digital health virtual care telehealth and telemed icine are all terms often used interchangeably to refer to the practice of care
toltonsumer fee-for-service model but these services contribute to fraqmentation of care and do not allow for documentation in UnclassifiedFor Public Use
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use gJ MASSACHUSETTS
middotbull GENERAL HOSPITAL TELEHEALTH
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e -ASPR
ANT bulllCatrtbull~ ~obull HUtTHCtH hoUGpoundNC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
Supporting the Mission and Objectives of the Response
1 Reduce staff exposures and risk
2 Preserve the essential human elements of care
3 Address barriers and inequality
11
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO NGAIEWAf
Virtual Care Tech - Tablets
VICS (Video Intercom Communication
System)
VICS Rounding Tablet
(for non-unit staff) Patient Connect
- MASSCH USEITS GE ERAL HOSPITAL
- ToLEHEALTH
Wii11 MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e 12
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use liJII MASSACHUSETTS V GENERAL HOSPITAL
TELEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH0Npound~~ I NfORMATIO N GAIEWAf
COVID-19 Response Areas Video Intercom System (VICS) bull Allows for providers to communicate with patients at the bedside via tablet
Limited Virtual Consults bull Minimize patient transfers increase access to care
Virtual Rounds bull Allows for providers to communicate with patients at the bedside via tablet
PatientConnect bull Enables virtual connections for admitted patients on hospital-provided
devices bull Familyfriends providers interpreters
13
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use
---~- ilillllllllllillil-llllilillliillll-lllliilllll___Bbullbullbullbullbull bull A f) NEWS WEATHER SPORTS COMMlJTE FOOD CULTURE TRAVEL EVENTS CARS REAL ESTATE ALL
Btlli MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
A Boston couple got married in the ICU at Mass General Two days lat er the groom passed away That was o ne of t he m ain t hings t hat he wanted to do to be able to marr y her To know t hat he got t he opportunit y to do t hat was beautif ul middotmiddot
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATION GATEWAY
UsesImpact
Patient Connect
Virtual Rounds
VICS (Video Intercom Communication
System)
14
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use Bt111 MASSCH USEITS bull GE ERAL HOSPITAL
- lELEHEALTH
UsesImpact
Isolation Hotel
Boston Hope (Boston Convention Center)
Wii11 MASSACHUSrrtS bull C1-NEKAL JiOPllAL
CFNTF R A)8
D IM5TER MEDICI -e ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
15
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use Bt111 MASSCHUSEITS V GE ERALHOSPITAL
- TllLEHEALTH
g MASSACHUSrrtS bull C1-NE KAL JiOPllAL
CFNTF R A)8
D1M5TER MpoundD1c u -e ~~~~ UIPAUDgt1111 ~gtIC UfPO~H
HUtTHCdl h oUGpound NC1 HpoundhH 0 Npound~~ I NfORMATIO NGAIEWAf
Practical Considerations
bull Devices bull Bandwidth bull Use of an EMR bull Interpreter services bull Patientsrsquo technical facility
16
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Mary Connelly RN BSN Director Illinois Medical Emergency Response Team
UnclassifiedFor Public Use
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Potential uses ndash Medical consultation ndash Situational awareness ndash Footprintlogistics problem solving
18
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Equipment ndash Windows 10 Tablet Intel I7 Processor with 16 GB of
memory SSD hard drive An androidapple based cellular phone or tablet could be used
ndash HD USB Video Camera ndash Bluetooth or USB Wired Headset ndash Wi-Fi or Cellular based connectionhotspots
19
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Options ndash Portable ultrasound (android tablet utilized via
Adobe connect) ndash Bluetooth or USB connected Otoscope ndash Bluetooth or USB connected Stethoscope ndash Bluetooth connected cardiac monitor
20
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telehealth-Telemedicine Field Operations
bull Challenges ndash Security Utilize HSIN as an option ndash Access to broadband Particularly challenging in rural
areas or where broadband connections have been disrupted
ndash Fire walls Hospital IT may block user access
BEST PRACTICE Test it out frequently with all likely users
21
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use
TRACIE HEALTHCARE EMERGENCY PREPAREDNESS
INFORMATION GATEWAY
ASPR ASSISTANT SECRETARY ~-OR
PREPAREDNES S AND RESPONSE
Darren Sommer DO MBA MPH CEO Innovator Health Javits New York Medical Station
UnclassifiedFor Public Use
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Javits New York Medical Station
bull Multi-agency ACS bull 3000 max patient capacity bull 28 days of operations bull 119 peak day admissions bull 453 max census bull More than 1000 unique patients
23
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Capability
bull Northwell tele-psychiatry bull Language phone bull NYJMS telemedicine pilot
24
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Telemedicine Pilot Goals
bull Whether equivalent medical care could be provided by telemedicine
bull Would patients be receptive to care through telemedicine
bull Could the traditional workflow be mimicked bull Could a telemedicine model be scaled to other sites bull Could the bedside attendant support the remote
physician with no previous telemedicine training
25
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Pilot Data
bull 18 unique patients were seen bull 44 patient encounters over seven clinical days bull Used the same workflow and processes as previously
established by the traditional medical encounter bull Diagnostic capability stethoscope exam camera
vitals bull No EHR
26
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Developing a Healthcare Coalition Pediatric Surge Annex
ASPR TRACIE Three Domains
Resources
Moderator- Meghan Treber MS13ASPR TRACIE13
Denis FitzGerald MD13Division Director Field Operations and Response Office of Emergency Management and Medical Operations HHS ASPR
Alternate Care Site Framework
Alternate Care Site Toolkit
Overview of AAP and Pediatric Centers of Excellence
Paul D Biddinger MD FACEP13Emergency Preparedness Chief and Director of the Center for Disaster Medicine Massachusetts General Hospital13
Screenshots of Articles
Supporting the Mission and Objectives of the Response
Virtual Care Tech - Tablets
COVID-19 Response Areas
UsesImpact
UsesImpact
Practical Considerations
Mary Connelly RN BSN13Director Illinois Medical Emergency Response Team
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Telehealth-Telemedicine Field Operations
Darren Sommer DO MBA MPH13CEO Innovator Health Javits New York Medical Station13
Javits New York Medical Station
Telemedicine Capability
Telemedicine Pilot Goals
Pilot Data
Lessons Learned
Best Practices
Question amp Answer
Contact Us
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Lessons Learned
bull Comparable medical care was able to be delivered bull Patientrsquos were very receptive appreciated no mask bull Rapid deployment is possible but not preferred bull Competing agendas need to be addressed bull Scalability is feasible
27
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Best Practices
bull Plan and train in advance bull Develop an SOP and brief stakeholders as early as
possible bull Set-up telemedicine programs now and learn from
controlled practices bull Someone must know the process bull Donrsquot be afraid to give it a shot bull Mimic the traditional workflow where possible
28
UnclassifiedFor Public Use ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY
Question amp Answer
29
UnclassifiedFor Public Use -ASPR ANT bulllCatrtbull~ ~obull HUtTHCtH h oUGpound NC1 HpoundhHONpound~~ UIPAUDgt1111 ~NC UfPO~H INfORMATIO N GATEWAY