Diagnosis of a Case of Suspected COVID-19 Using Telemedicine Technology in the Emergency Department

Patient: Male, 67-year-old Final Diagnosis: COVID-19 Symptoms: Fever Medication: — Clinical Procedure: — Specialty: Disaster Medicine • Infectious Diseases OBJECTIVE: Management of emergency care BACKGROUND: Coronavirus disease 2019 (COVID-19) is an ongoing worldwide pandemic infection. Healthcare workers must utilize appropriate personal protective equipment (PPE) and infection control prevention techniques given the high risk of transmission and potential morbidity associated with COVID-19. We present a case report highlighting the strengths and potential applications of telemedicine technology in a patient’s evaluation during an ongoing emerging, novel infectious disease. CASE REPORT: A 67-year-old male presented to the Emergency Department (ED) with complaints of fever. His presentation coincided with a recent declaration of a pandemic caused by COVID-19 and a known exposure. Telemedicine evaluation was performed using InTouch Provider(®) software (InTouch Health, Goleta, CA, USA). The treating clinician was able to interact with the patient entirely through observations via web camera. COVID-19 nasopharyngeal swab polymerase chain reaction testing was ordered and was performed by a dedicated triage nurse. The patient was deemed stable for discharge given his normal vital signs and well appearance. Approximately 72 hours after discharge from the ED, the patient was contacted with positive COVID-19 swab results. CONCLUSIONS: We present the first known case report highlighting use of telemedicine to diagnosis COVID-19 in a patient present in the ED. With the appropriate systems in place, this method of evaluating the patient helped to limit clinician exposure, decrease risk of transmission to key personnel, and assisted with preserving PPE supplies. Use of telemedicine affords multiple benefits in the effective diagnosis, evaluation, and potential prevention of spread of COVID-19.