The establishment of a telemedicine center during the COVID-19 pandemic at a tertiary care hospital in Pakistan

Background

Telemedicine involves the innovative application of technology to provide remote patient healthcare services especially those relating to emergency care and contagious disease spread. Telemedicine is less developed in low-and-middle-income countries like Pakistan and there is little published literature on its function and efficiency. Our institution was established to triage patients with COVID-19 symptoms to ease the load on emergency departments.

Objective

To conduct an analysis of the first month of function of a telemedicine/tele-triage center in Pakistan. To determine in which ways it was beneficial to hospital management during the COVID-19 pandemic.

Methods

This study was carried out at the newly established telemedicine/tele-triage center at the Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU) in Islamabad Pakistan between the 26th March and the 25th April 2020. Data were collected over telephone interview using a proforma to provide each caller with a C-Score (a C-score of >3 indicated observe at home 3–5-indicated home isolation with confirmatory testing and >5 indicated testing and transfer to hospital) representing their COVID-19 risk and informing the nature of the advice given to them. Data were presented using descriptive statistics.

Results

The center received total of 857 calls. Fever cough dyspnea and flu were present in 327(38.2%) 268(31.3%) 107(12.5%) and 124(14.5%) callers respectively. Based on the completion of the proforma 774(90.3%) callers had a C-Score of > 75(8.8%) callers had a C-Score of 3–5 and 8 (0.9%) callers had a C-Score of >5. We recommended COVID-19 testing in 83 patients (9.68%) based on C-score. Out of these 83 patients 64 underwent testing and only 1 tested positive for COVID-19.

Conclusion

In a one-month period the center was able to support patients by providing a triage service thereby preventing numerous unnecessary hospital visits and helping to protect healthcare professionals during a global pandemic. Telemedicine has great potential to help patient populations in low-and-middle-income countries.