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Gorbenko K, Mohammed A, Ezenwafor E, Phlegar S, Healy P, Solly T, Nembhard I, Xenophon L, Smith C, Freeman R, Reich D, Mazumdar M. Innovating in a Crisis: A Qualitative Evaluation of a Hospital and Google Partnership to Implement a COVID-19 Inpatient Video Monitoring Program. J Am Med Inform Assoc 2022; 29:1618-1630. [PMID: 35595236 PMCID: PMC9129147 DOI: 10.1093/jamia/ocac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/10/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To describe adaptations necessary for effective use of direct-to-consumer (DTC) cameras in an inpatient setting, from the perspective of health care workers. Methods Our qualitative study included semi-structured interviews and focus groups with clinicians, information technology (IT) personnel, and health system leaders affiliated with the Mount Sinai Health System. All participants either worked in a coronavirus disease 2019 (COVID-19) unit with DTC cameras or participated in the camera implementation. Three researchers coded the transcripts independently and met weekly to discuss and resolve discrepancies. Abiding by inductive thematic analysis, coders revised the codebook until they reached saturation. All transcripts were coded in Dedoose using the final codebook. Results Frontline clinical staff, IT personnel, and health system leaders (N = 39) participated in individual interviews and focus groups in November 2020–April 2021. Our analysis identified 5 areas for effective DTC camera use: technology, patient monitoring, workflows, interpersonal relationships, and infrastructure. Participants described adaptations created to optimize camera use and opportunities for improvement necessary for sustained use. Non-COVID-19 patients tended to decline participation. Discussion Deploying DTC cameras on inpatient units required adaptations in many routine processes. Addressing consent, 2-way communication issues, patient privacy, and messaging about video monitoring could help facilitate a nimble rollout. Implementation and dissemination of inpatient video monitoring using DTC cameras requires input from patients and frontline staff. Conclusions Given the resources and time it takes to implement a usable camera solution, other health systems might benefit from creating task forces to investigate their use before the next crisis.
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Affiliation(s)
- Ksenia Gorbenko
- Icahn School of Medicine at Mount Sinai, Population Health Science and Policy, Mount Sinai Health System, New York, USA.,Institute for Health Care Delivery Science, Mount Sinai Health System, New York, USA
| | - Afrah Mohammed
- Department of Clinical Innovation, Mount Sinai Health System, New York, NY, USA
| | - Edward Ezenwafor
- Institute for Health Care Delivery Science, Mount Sinai Health System, New York, USA
| | - Sydney Phlegar
- Institute for Health Care Delivery Science, Mount Sinai Health System, New York, USA
| | - Patrick Healy
- Department of Clinical Innovation, Mount Sinai Health System, New York, NY, USA
| | | | | | | | - Cardinale Smith
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Robert Freeman
- Department of Clinical Innovation, Mount Sinai Health System, New York, NY, USA
| | - David Reich
- The Mount Sinai Hospital, New York, USA.,Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Madhu Mazumdar
- Icahn School of Medicine at Mount Sinai, Population Health Science and Policy, Mount Sinai Health System, New York, USA.,Institute for Health Care Delivery Science, Mount Sinai Health System, New York, USA
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