“Novel Use of Telepalliative Care in a NYC Emergency Department During the COVID-19 Pandemic”

Abstract Coronavirus-2 (COVID-19) is a global pandemic. As of April 24th, mortality from COVID-19 has reached almost 200,000 people, with the United States (US) leading the globe in levels of morbidity and mortality. Large volumes of high acuity patients, particularly those of advanced age and with chronic co-morbidities, have significantly increased the need for palliative care resources beyond usual capacity. More specifically, COVID-19 has changed the way we approach patient and family member interactions. Concern for nosocomial spread of this infection has resulted in strict visitation restrictions that have left many patients to face this illness, make difficult decisions, and even die, alone in the hospital. In order to meet the needs of COVID patients, services such as Emergency Medicine and Palliative Care have responded rapidly by adopting novel ways of practicing medicine. We describe the use of telepalliative medicine (TM) implemented in an Emergency Department (ED) setting to allow family members the ability to interact with their loved ones during critical illness, and even during end of life. Use of this technology has helped facilitate goals of care discussions, in addition to providing contact and closure for both patients and their loved ones. We describe our rapid and ongoing implementation of TM consultation for our ED patients and discuss lessons learned and recommendations for others considering similar care models.