As one of the deliverables of the COVID-19 Telehealth Resource Center’s funding for projects associated with response to COVID 19, the National Telehealth Technology Assessment Center (TTAC) developed a Pandemic Response Project Team or “Think Tank” to create an Action Plan to support rural and urban communities in a return or continuation of COVID-19 – or a future pandemic – applying telemedicine capabilities and technologies. The “Think Tank” was assembled with multiple representatives from epidemiology/infection control, hospital CEOs, nursing, public health, technology, regulatory and policy as well as representatives from TTAC. (See brief bios of the Think Tank members here) This team identified and explored, through structured brainstorming, critical issues facing healthcare delivery systems during a pandemic in three scenarios.
- Scenario #1) A remote hospital in Alaska;
- Scenario #2) A small urban hospital serving a primarily rural population;
- Scenario #3) A medium-sized urban hospital which also serves a surrounding non-urban service area.
Each key issue was explored and discussed. The drivers, challenges and potential solutions were explored. Additional research was done on all key issues to give examples and context.
The project has three phases and three components:
Phases:
- The first is to complete a Draft Pandemic Action Plan in time to be of value for the 2020 COVID-19/flu season. This will identify and explore key issues/challenges and identify technology solutions for each.
- The second is to complete the Final Plan which will include everything in the Draft Plan plus a technology assessment/evaluation of the technologies identified in the Draft Plan.
- The third involves the team working with additional Telemedicine Resource Centers to identify examples where telemedicine and related technologies were used and what types of technology were used in the current COVID-19 pandemic and then describe the results, challenges, updated recommendations, etc.
Components:
- The Pandemic Action Plan – This document.
- Pandemic Action Plan Technology Deep Dive – This gives examples and links to each of the technologies available to address the issues and “Ideas” in the Pandemic Action Plan. In Phase 1 and 2, this is a listing. In Phase 3, it will also include assessment of selected technologies by the National Telemedicine Technology Assessment Center. Specific examples of technology to support the Ideas listed are in included in this companion document: Pandemic Action Plan Technology Deep Dive
- Pandemic Action Plan Policy and Regulatory Summary – This gives a look at current policy and regulations as well as recommendations for policy and regulatory changes to allow and encourage implementation of this plan and telemedicine in general.
This document represents the completion of Phase 2 (Final Plan). Phase 3 compilation is currently targeted for June 2021. Note: For purposes of this effort, telemedicine and telehealth are used interchangeably throughout all three documents.
Summary:
The Pandemic project team initially identified and explored fourteen critical needs/challenge areas. All of these topics were deemed critical and were explored in detail. After discussion, two of the topic areas were determined to be beyond the scope of the project (Supplies Acquisition and Data Gathering/Contact Tracing) because the team could not identify telemedicine-related technology to properly address them. After further exploration, it was determined that two other topics should be combined because they had significant overlap in both requirements and potential solutions. This left eleven challenges – critical issues that are addressed by this document:
- Keeping care protocols up-to-date
- Keep the hospital open (operations, care delivery, quality, revenue)
- Divert the potentially infected before they arrive at the hospital
- Replace / cover for infected staff, provide for critical care staff needs
- COVID-19 containment in the hospital/clinic
- Provide access to urgent care, ongoing care/follow-up care for current patients (hospital, private practitioners, rehabilitation, etc.)
- Provide care at home, create ability to rotate patients out of the hospital to make room for monitoring more critical cases, (monitoring, RPM, CDM, address technical issues, care support, monitoring, deal with issues of isolation and quarantine/patient safety)
- Support remote work for staff
- Behavioral health, (support for patients, staff, community; address needs and fears of staff)
- Transportation (replacement of current options that may no longer exist or be practical for people, patients, supplies, treatment equipment, critical pharmaceuticals)
- Public Health, (provide support for community communications, accurate information, training to the community)