Maximizing Efficiency of Telemedicine in the Skilled Nursing Facility during the Coronavirus Disease 2019 Pandemic.

The project measured only the percentage of rounding time spent on nonclinical troubleshooting; it did not measure quality of care, patient outcomes, or hospitalizations. It was done in 2 skilled nursing facilities with COVID-19 outbreaks, so staffing shortages and local conditions may not apply elsewhere. There was no control group or random allocation; changes were made through quality improvement cycles, so other factors could have affected the time measure. The optimized workflow included many changes at once, so the contribution of any single component cannot be separated. The authors note that minimum staffing rules may make the protocol hard to copy in other nursing homes. The authors state that strong evidence does not yet exist for efficacy or effectiveness, so outcomes cannot be assured.

Do not conclude that telemedicine rounds improved patient care, reduced hospitalizations, or are proven effective. The project measured time lost to technical troubleshooting, not clinical outcomes, and the authors say strong evidence for efficacy or effectiveness does not exist.