Methods: In conjunction with hospital administration, video carts were set up in network with computers in office and hospital settings where ID providers attended. A process was established to consult with on-call ID provider and virtual connection was made at designated times. Bedside nursing assisted ID provider with face-to-face visit with patients. Documentation was made in the EMR and follow up visits were set up as needed. We reviewed all patients for principal and secondary diagnosis, transfer to tertiary facility, 30-day readmission, and outpatient follow up.
Results: During period from 1/15 to 12/15, ID consultation was provided for 312 unique patients in a 175 bed facility. There were 583 total visits, 149 patients were seen only for initial consult and 163 patients had at least 1 hospital follow up visit. The most common reasons for consultation were bacteremia, skin/soft tissue infection, osteomyelitis/prosthetic joint infection, and UTI. There were only 13 patients who required transfer to a tertiary facility with the majority transferred for surgical evaluation. 91 patients (29%) were prescribed OPAT written by ID physician. The 30-day readmission rate for all patients was 20% with only 14 (4%) patients readmitted for ID related complications.
Conclusion: Using virtual technology, we were able to successfully set up a face-to-face ID consult service at a community hospital. The reasons for consult mirrored that typical for inpatient ID consultation and patients received usual care including outpatient antibiotics. Few patients required transfer to tertiary facility and readmissions for ID related issues were limited. Use of virtual technology is a viable option to extend the ID workforce into more remote community hospitals.
T. Verville, None
V. Mehta, None
J. Hicks, None
G. Glorioso, None