NYC Hospitals Create Blueprint for COVID-19 Triage By Telehealth

The report, recently published in Medicina, was prepared by clinicians at NYU Langone Health and the NYU Long Island School of Medicine, both of which used telehealth to treat hundreds of thousands of patients this summer.

By Eric Wicklund

September 21, 2020 – Two New York health systems have published a blueprint for using telehealth to diagnose and treat patients infected with the coronavirus.

The report, “A Telemedicine Approach to COVID-19 Assessment and Triage,” was published earlier this month in the scientific and medical journal Medicina by researchers and clinicians from NYU Langone Health and the NYU Long Island School of Medicine. It offers guidelines on how to triage patients who may have COVID-19 and use virtual care platforms to treat them in isolation.

Those involved with the report are speaking from experience. Telehealth visits at the two health systems jumped from 50 a day to more than 7,000 from March to April, when New York City was at the center of the coronavirus pandemic in the US. By this past August, more than 550,000 patients had been screened through a virtual platform.

The report offers a blueprint for using telemedicine technology to assess a patient based on criteria established by the Centers for Disease Control & Prevention, including using audio-visual platforms and common household tools like a flashlight to conduct an exam.

It also notes that telehealth might not be appropriate in every situation. Drawbacks to an effective telehealth visit include lack of broadband or technology, as well as patients who don’t have the digital literacy to use the technology, particularly in low-income and underserved areas. There may also be problems with privacy and security, patients who have disabilities that interfere with the technology or patients who simply prefer in-person care.

“The rapid expansion of telemedicine in response to the COVID-19 pandemic allows physicians to safely maintain connections to their patients in a way never before achieved – whether involving COVID-related or other medical issues,” Eric R. Goldberg, MD, senior medical director and clinical associate professor in the Department of Medicine at NYU Langone Health, said in a press release. “Telemedicine can also create deeper connections between a physician and patient, emanating from the personal spaces shared by each.”

“Most physicians have never before practiced telemedicine, and in this new world of a pandemic, our guidelines serve as a blueprint for safe and effective COVID-19 assessments,” added Allison B. Reiss, MD, an associate professor in the Department of Medicine at NYU Long Island School of Medicine, head of the Inflammation Laboratory at the Research Institute at NYU Winthrop Hospital and the report’s lead author.

Pressed by the need to separate potentially infected patients from care providers, health systems across the country scaled up or launched telehealth platforms in record number this past summer. Many are now trying to stabilize the balance between virtual and in-person care, and they’re looking to use these tools beyond the COVID-19 crisis in remote patient monitoring programs for everything from triage to chronic care management to post-discharge care.