Virtual visitation

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Virtual visitation, also known as virtual visits and video visits, is the use of video calling technology to facilitate communication between hospitalized patients and their loved ones when physical visits are unable to be facilitated. Virtual visitation is distinct from telemedicine because the former is a video call is between patient and their family or friends, which may or may not include any healthcare personnel. Virtual visitation became widely adopted in 2020 because of visitation restrictions due to the COVID-19 pandemic.

Overview

Virtual visitation usually occurs between a patient who is admitted to a healthcare facility and their friends or family who are unable to visit the healthcare facility in person. The visit can be for emotional and social support[1], or to facilitate medical decision making with, or on behalf of, the patient. In some cases, more than two parties can be on the call using video conferencing technology. The involvement of the healthcare team in such calls may also be called telerounding (occurring during daily rounds, for example) or virtual family meeting (occurring with the patient and healthcare team at a time separate from daily rounds).

During the COVID-19 pandemic, most hospitals and other healthcare facilities (such as nursing homes and assisted living facilities) restricted visitation from family and friends in order to limit transmission of the SARS-CoV-2 virus. Such restrictions prompted many facilities to implement virtual visitation to provide meaningful communication between patients and their loved ones.

Technology

Virtual visitation requires technology to facilitate the visit. Both the patient (or healthcare facility where the patient is admitted) and the family or friends need to have the hardware, software, and adequate bandwidth for a successful visit to occur. Additionally, the ability to operate and troubleshoot the hardware and software on both ends of the call is required.[2]

Hardware

Frequently, patients have their own smartphone, tablet, or laptop computer with them at the healthcare facility. However, when hardware is unavailable or the patient is unable to operate the hardware (for example, due to severity of illness), then some healthcare facilities are able to provide hardware, often in the form of a tablet, for the patient to use. The patient’s family and friends must have access to and be able to operate their own device.

Software

A number of readily available video calling apps have been utilized for virtual visitation, including Skype, WhatsApp, FaceTime, Zoom, and Google Hangouts. The specific app that is used should take into consideration the type of device (e.g. FaceTime is only available for Apple products) that is available to all parties. There have also been privacy and security concerns with regard to some of the video calling apps.

Asynchronous videoconferencing technology has also been used to video-record rounding for families to review at another time.[3]

Bandwidth

Both parties must have adequate bandwidth to support the video call, which includes both download and upload speeds. If videoconferencing (i.e. more than two parties) is desired, then more bandwidth may also be needed. In situations where there is heavy simultaneous use of videoconferencing, for example during the COVID-19 pandemic, then the bandwidth must be even greater to support all of the calls. Ability to operate and troubleshoot There must be at least one person on each end of the video call or video conference who is able to operate the device and make the connection to the call, and also be able to troubleshoot if there are any problems which occur with starting the call or during the call.

Personnel

Even with the availability of the above technologies, the availability of personnel to assist with the use of the technology can be a limitation in the utility of virtual visitation. Due to infection control concerns and limited personal protective equipment (PPE) supplies, there may be limited ability for nurses or other caregivers to enter patient rooms to assist with virtual visitation. However, some hospitals have addressed this need by redeploying healthcare workers from other settings.[3][4]

Healthcare settings

Virtual visitation has been implemented in different healthcare settings and for different purposes. Some examples of adaptations for specific needs are described in this section.

Pediatrics

Intensive care units

Palliative care and hospice

Long-term care facilities

Reception

Criticism of the use of virtual visitation primarily centers on its use as a substitute for in person visitation, as an argument against the visitation restrictions at healthcare facilities.

Setting up an iPad to prevent patients from dying alone is not a solution.[5]

See also

Telemedicine – video calling technology used to conduct a healthcare encounter between a patient and a healthcare provider.

Notes

References

  1. Abel J, Taubert M. Coronavirus pandemic: compassionate communities and information technology. BMJ Support Palliat Care. 2020.
  2. Using Skype during Pandemic Isolation - BMJ Supportive & Palliative Care
  3. 3.0 3.1 Billingsley L. Using Video Conferencing Applications to Share the Death Experience During the COVID-19 Pandemic. J Radiol Nurs. 2020.
  4. MetroHealth's Compassionate Care Rounders (video)
  5. Andrist E, Clarke RG, Harding M. Paved With Good Intentions: Hospital Visitation Restrictions in the Age of Coronavirus Disease 2019. Pediatr Crit Care Med. 2020;21(10):e924-e6.

External links

Kaweah Delta Virtual Visitations - example of virtual visitation implemented at one hospital.

Submitted by Da Jin --Dpjin (talk) 22:56, 19 October 2020 (UTC)