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.