ISOCOMS Telemedicine Platform Useful for Patient Care in a Biocontainment Unit

By Marilynn Larkin

May 16, 2020

NEW YORK (Reuters Health) - The isolation Communication Management System (iSOCOMS) telemedicine platform developed at a Virginia hospital to manage patients during an Ebola virus disease outbreak has also demonstrated benefits during the COVID-19 pandemic, researchers there say.

iSOCOMS "has been incredibly helpful during several common scenarios we've faced during the COVID-19 pandemic," Dr. Kyle Enfield of the University of Virginia Medical Center in Charlottesville told Reuters Health by email. "First, we've used it extensively while providing direct care in the hospital for COVID-19 patients. Second, it's helped patients stay connected with families. And third, it's proven to be a huge asset in managing complex nursing home outbreaks in our community."

"Our providers have used iSOCOMS to communicate and interact with patients while limiting PPE use," he said. "While we have not fully analyzed our data, we have heard iSOCOMS described as a 'game changer' by our nursing staff."

Dr. Enfield and colleagues describe the suite of telemedicine tools in a report in Annals of the American Thoracic Society. Assessments of case use scenarios revealed that, among other benefits, iSOCOMS:

- Enables one instead of two healthcare professionals to care for a patient in the biocontainment room, with the other professional monitoring the patient and assisting in tasks such as integration of support services and documentation from outside the room.

- Facilitates provider-to-patient communication and establishment of a rapport between the two. Dr. Enfield noted that currently "patients are averaging more than 80 video interactions per admission," resulting in PPE savings of 25%-50% per inpatient stay.

- Improves monitoring of patient care by, for example, enabling the observer to watch for and warn against breaches in PPPE in real time, or to determine whether the provider in the room is becoming uncomfortable or fatigued.

- Enables tracking of patient movement into the unit - for example, iSOCOMS was used to monitor Ebola patient transport from outside the medical center (after arriving by ambulance) through designated, secured corridors and elevators and into the special pathogens unit.

Other potential uses include video-enabled consultation; facilitation of support from family members, chaplains and counselors; and facilitation of student/learner involvement without risk of exposure in the biocontainment room, according to the researchers.

Planning ahead can pay dividends, Dr. Enfield said.

"By recognizing the utility of iSOCOMS early, we were able to rapidly deploy more than 140 endpoints though our health system and manage the technical challenge of managing multiple video calls each day," he said. "By partnering early with our telemedicine team, we were able to build upon our experience as an Ebola treatment center during this pandemic."

Dr. Waleed Javaid, Director of Infection Prevention and Control at Mount Sinai Downtown in New York City, commented in an email to Reuters Health, "This iSOCOMS system is very interesting and I think it is modifiable for any pathogen. For infectious diseases like Ebola, Marburg, and other...highly pathogenic organisms, this approach is workable and perhaps preferable by limiting the number of staff exposures," he said.

However, he added, "The ability to scale this system will be a challenge."

"Also, care required for COVID-19 patients, including the need for intubation, is not achievable remotely," he noted. "Taking care of a few patients remotely is possible, but with COVID-19, we saw an overwhelming number of patients, for which such a system will not be functional."

SOURCE: Annals of the American Thoracic Society, online May 1, 2020.