The Use of Smartphones and Tablets for Video Visits Between Patients and Families During the Height of COVID-19 in New York City

Rationale: In March of 2020, New York City became an epicenter of COVID-19. Due to the risk of airborne transmission and limited personal protective equipment, hospitals restricted patient visitations to protect both healthcare workers and patients. In response to the initiation of this visitation restriction at our hospital on March 18, 2020, we piloted a video-based communication program for families to virtually “visit” their family members in the hospital. This is a quality improvement project designed to evaluate the utility and limitations of these virtual family visits during the pandemic. Methods: A retrospective chart review was conducted of all patients over 17 years-old hospitalized between March 18 and May 31, 2020 for documented video encounters performed by hospital staff at a New York City public hospital. All video calls were performed using Whatsapp, Facetime, or Google Hangout communication app on a hospital-issued smartphone or tablet. Data collected included date of call, patient age, call facilitator, preferred language, patient location during hospitalization, use of mechanical equipment for assisted breathing, hospital length of stay, patient disposition, discharge diagnosis, and any additional limitations noted by the staff during video visits. Patients admitted to the psychiatric, rehabilitation, pediatric, labor and delivery, forensics wards, or if only a voice call was performed, were excluded. Results: Of the 2068 hospitalizations qualified for chart review, 177 patients have thus far been identified with documented video visits. A total of 1416 video visits were performed in these patients. 71.0% of the patients were intubated during their hospitalization and when video visits occurred. 37.3% of the patients expired, while 24.9% were discharged home or to a short-term rehabilitation center (38.9%). The average length of stay was 35.2 days (SD 2.1). Majority of the diagnoses were COVID-related illnesses (61.0%). Social workers conducted 78.5% of the video visits, followed by physicians (57.7%) and hospital chaplains (9.6%). Average patient age was 62 years-old. Chart review process is currently ongoing. Conclusions: The use of smartphones and tablets for video visits facilitated communication between patients and their families when in-person visits were restricted. We were able to provide visual visits to families when patients were intubated and were unable to verbalize. While a significant number of patients expired during this period, families were able to “see” and communicate with their family members prior to their deaths. The use of this technology is an invaluable tool for families to communicate and partake in patient care. .