Impact of a telemedicine system on work burden and mental health of healthcare providers working with COVID-19: a multicenter pre-post prospective study

Nobuyuki Kagiyama; Takayuki Komatsu; Masanori Nishikawa; Makoto Hiki; Mariko Kobayashi; Wataru Matsuzawa; Hiroyuki Daida; Tohru Minamino; Toshio Naito; Manabu Sugita; Kunihisa Miyazaki; Hideaki Anan; Takatoshi Kasai

doi:10.1093/jamiaopen/ooac037

Impact of a telemedicine system on work burden and mental health of healthcare providers working with COVID-19: a multicenter pre-post prospective study

JAMIA Open. 2022 May 20;5(2):ooac037. doi: 10.1093/jamiaopen/ooac037. eCollection 2022 Jul.

Authors

Nobuyuki Kagiyama^{1

2}, Takayuki Komatsu³, Masanori Nishikawa⁴, Makoto Hiki^{2

5}, Mariko Kobayashi⁶, Wataru Matsuzawa⁶, Hiroyuki Daida^{1

2}, Tohru Minamino², Toshio Naito⁷, Manabu Sugita³, Kunihisa Miyazaki⁸, Hideaki Anan⁹, Takatoshi Kasai^{1

2

10}

Affiliations

¹ Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan.
² Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
³ Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Tokyo, Japan.
⁴ Department of Respiratory Medicine, Fujisawa City Hospital, Fujisawa, Japan.
⁵ Department of Emergency Medicine, Juntendo University, Tokyo, Japan.
⁶ Ogino Memorial Laboratory, Nihon Kohden Corporation, Tokyo, Japan.
⁷ Department of General Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan.
⁸ Department of Surgery, Tokyo-Kita Medical Center, Tokyo, Japan.
⁹ Emergency Medical Center, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan.
¹⁰ Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic impacts not only patients but also healthcare providers. This study seeks to investigate whether a telemedicine system reduces physical contact in addressing the COVID-19 pandemic and mitigates nurses' distress and depression.

Methods: Patients hospitalized with COVID-19 in 4 hospitals and 1 designated accommodation measured and uploaded their vital signs to secure cloud storage for remote monitoring. Additionally, a mat-type sensor placed under the bed monitored the patients' respiratory rates. Using the pre-post prospective design, visit counts and health care providers' mental health were assessed before and after the system was introduced.

Results: A total of 100 nurses participated in the study. We counted the daily visits for 48 and 69 patients with and without using the telemedicine system. The average patient visits were significantly less with the system (16.3 [5.5-20.3] vs 7.5 [4.5-17.5] times/day, P = .009). Specifically, the visit count for each vital sign assessment was about half with the telemedicine system (all P < .0001). Most nurses responded that the system was easy to use (87.1%), reduced work burden (75.2%), made them feel relieved (74.3%), and was effective in reducing the infection risk in hospitals (79.1%) and nursing accommodations (95.0%). Distress assessed by Impact of Event Scale-Revised and depression by Patient Health Questionnaire-9 were at their minimum even without the system and did not show any significant difference with the system (P = .72 and .57, respectively).

Conclusions: Telemedicine-based self-assessment of vital signs reduces nurses' physical contact with COVID-19 patients. Most nurses responded that the system is easy and effective in reducing healthcare providers' infection risk.

Keywords: COVID-19; information and communication technology; noncontact monitoring; respiratory monitoring; telemedicine.