NEW ORLEANS – Due to the ongoing decline in the infectious disease (ID) workforce, ID evaluations are limited in outlying community hospitals.  Using virtual technology to set up face-to-face ID consultations appears to be a practical resource for providing ID-related clinical services in underserved communities, according to a presentation at IDWeek 2016.

Researchers from the Carolinas Healthcare System in Charlotte and Monroe, North Carolina, worked with hospital administration to set up video carts in network with computers in office and hospital settings where ID care providers attended.  Nurses assisted the ID care provider with the virtual face-to-face visit with patients.  Electronic medical records were used for documentation and follow-up visits, as needed. 

A total of 312 patients from a 175-bed facility underwent ID consultation between January and December 2015.  Initial consultation was conducted for 48% (149) of patients, while 52% (163) of patients had ≥1 hospital follow-up visit. Bacteremia, skin/soft tissue infection, osteomyelitis/prosthetic joint infection, and urinary tract infection were the most frequent diagnoses requiring evaluation.  Patients were reviewed for principal and secondary diagnoses, transfer to tertiary facilities, 30-day readmissions, and outpatient follow-up.


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Outpatient parenteral antimicrobial therapy was prescribed for 29% of patients who underwent consultation via virtual technology.  The 30-day readmission rate was 20% for all patients; 4% of patients required hospital readmission for ID-related complications.  Only 13 patients were transferred to a tertiary facility, most of which were for surgical evaluation.

Since patients received usual care including outpatient antibiotics, the investigators concluded that the “use of virtual technology is a viable option to extend the ID workforce into more remote community hospitals.”

Reference

McCurdy L, Lackey P, Verville T, Mehta V, Hicks J, Glorioso G. The successful use of telemedicine with virtual face-to-face evaluation for inpatient infectious disease consultation. Presented at: IDWeek 2016. New Orleans, LA; October 26-30, 2016. Abstract 1682.