Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 22, 2020
Date Accepted: Jun 15, 2020
Date Submitted to PubMed: Jun 16, 2020
Double-Triage and Telemedicine Protocol in Optimizing Infection Control in an Emergency Department in Taiwan During the Coronavirus Disease Pandemic: A Retrospective Study
ABSTRACT
Background:
Frontline healthcare workers, including physicians, are at a high risk of coronavirus disease (COVID-19) owing to their exposure to patients suggested of having COVID-19.
Objective:
To evaluate the benefits and feasibility of a double-triage and telemedicine protocol in improving infection control in the emergency department (ED).
Methods:
In this retrospective study, we recruited patients aged > 20 years referred to the ED of the National Taiwan University Hospital between March 1 and April 30, 2020. A double-triage and telemedicine protocol was developed to triage suggested COVID-19 cases and minimize health workers’ exposure to this disease. We categorized patients attending video interviews into the telemedicine group (TG) and those experiencing face-to-face interviews into the conventional group (CG). A questionnaire was used to assess how patients perceived the quality of the interviews, their communication with physicians, stress, discrimination, and privacy. Each question was evaluated using the 5-point Likert scale. Physicians’ total exposure time (TEXT) and the total evaluation time (TEVT) were treated as primary outcomes and the mean scores for questions as secondary outcomes.
Results:
The final sample included 198 patients, including 93 cases in TG and 105 cases in CG. The TEXT in TG was significantly shorter than that in CG (4.7 min vs. 8.9 min; P < .001), whereas the TEVT in TG was significantly longer than that in CG (12.2 min vs. 8.9 min, P < .001). After controlling for potential confounders, the TEXT in TG was 4.6 minutes shorter than that in CG (95% confidence interval [CI]: −5.7 to −3.5, P < .001), whereas the TEVT in the former group was 2.8 minutes longer than that in the latter group (95% CI: −1.6 to −4.0, P < .001).
Conclusions:
The implementation of the double-triage and telemedicine protocol in the ED during the COVID-19 pandemic has a high potential in improving infection control.
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