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Telemedicine implementation in Covid-19 ICU : balancing physical and virtual forms of visibility

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Putievsky Pilosof, Nirit, Oborn, Eivor, Barkai, Galia, Pessach, Itai and Zimlichman, Eyal (2021) Telemedicine implementation in Covid-19 ICU : balancing physical and virtual forms of visibility. Health Environments Research and Design Journal, 14 (3). pp. 34-48. doi:10.1177/19375867211009225 ISSN 1937-5867.

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Official URL: https://doi.org/10.1177/19375867211009225

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Abstract

Objective:
This case study examines the implementation of inpatient telemedicine in COVID-19 intensive care units (ICUs) and explores the impact of shifting forms of visibility on the management of the unit, staff collaboration, and patient care.

Background:
The COVID-19 crisis drove healthcare institutions to rapidly develop new models of care based on integrating digital technologies for remote care with transformations in the hospital-built environment. The Sheba Medical Center in Israel created COVID-19 ICUs in an underground structure with an open-ward layout and telemedicine control rooms to remotely supervise, communicate, and support the operations in the contaminated zones. One unit had a physical visual connection between the control room and the contaminated zone through a window, while the other had only a virtual connection with digital technologies.

Methods:
The findings are based on semistructured interviews with Sheba medical staff, telemedicine companies, and the architectural design team and observations at the COVID-19 units during March–August 2020.

Results:
The case study illustrates the implications of virtual and physical visibility on the management of the unit, staff collaboration, and patient care. It demonstrates the correlations between patterns of visibility and the users’ sense of control, orientation in space, teamwork, safety, quality of care, and well-being.

Conclusions:
The case study demonstrates the limitations of current telemedicine technologies that were not designed for inpatient care to account for the spatial perception of the unit and the dynamic use of the space. It presents the potential of a hybrid model that balances virtual and physical forms of visibility and suggests directions for future research and development of inpatient telemedicine.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Social Sciences > Warwick Business School
Library of Congress Subject Headings (LCSH): COVID-19 Pandemic, 2020- , Intensive care units -- Israel, Intensive care units -- Design and construction -- Israel, Critical care medicine -- Israel, Telecommunication in medicine -- Israel
Journal or Publication Title: Health Environments Research and Design Journal
Publisher: Sage
ISSN: 1937-5867
Official Date: 2 June 2021
Dates:
DateEvent
2 June 2021Published
1 July 2021Available
22 March 2021Accepted
Volume: 14
Number: 3
Page Range: pp. 34-48
DOI: 10.1177/19375867211009225
Status: Peer Reviewed
Publication Status: Published
Reuse Statement (publisher, data, author rights): Under SAGE's Green Open Access policy, this is the Accepted Version of the article and reuse is restricted to non-commercial and no derivative uses.
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 26 March 2021
Date of first compliant Open Access: 26 March 2021
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RG96631 NSAG/202Centre for Digital Built Britainhttps://www.cdbb.cam.ac.uk/
WMCLAHRC-2014-1National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Is Part Of: 1

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