scholarly journals Comparing Classroom Instruction to Individual Instruction as an Approach to Teach Avatar-Based Patient Monitoring With Visual Patient: Simulation Study

10.2196/17922 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e17922 ◽  
Author(s):  
Julian Rössler ◽  
Alexander Kaserer ◽  
Benjamin Albiez ◽  
Julia Braun ◽  
Jan Breckwoldt ◽  
...  
Keyword(s):  
Large Scale ◽  
Patient Monitoring ◽  
Vital Signs ◽  
Care Providers ◽  
Instruction Group ◽  
Anesthesia Providers ◽  
Individual Instruction ◽  
Significant Difference ◽  
Historical Sample ◽  
Class Instruction

Background Visual Patient is an avatar-based alternative to standard patient monitor displays that significantly improves the perception of vital signs. Implementation of this technology in larger organizations would require it to be teachable by brief class instruction to large groups of professionals. Therefore, our study aimed to investigate the efficacy of such a large-scale introduction to Visual Patient. Objective In this study, we aimed to compare 2 different educational methods, one-on-one instruction and class instruction, for training anesthesia providers in avatar-based patient monitoring. Methods We presented 42 anesthesia providers with 30 minutes of class instruction on Visual Patient (class instruction group). We further selected a historical sample of 16 participants from a previous study who each received individual instruction (individual instruction group). After the instruction, the participants were shown monitors with either conventional displays or Visual Patient displays and were asked to interpret vital signs. In the class instruction group, the participants were shown scenarios for either 3 or 10 seconds, and the numbers of correct perceptions with each technology were compared. Then, the teaching efficacy of the class instruction was compared with that of the individual instruction in the historical sample by 2-way mixed analysis of variance and mixed regression. Results In the class instruction group, when participants were presented with the 3-second scenario, there was a statistically significant median increase in the number of perceived vital signs when the participants were shown the Visual Patient compared to when they were shown the conventional display (3 vital signs, P<.001; effect size –0.55). No significant difference was found for the 10-second scenarios. There was a statistically significant interaction between the teaching intervention and display technology in the number of perceived vital signs (P=.04; partial η2=.076). The mixed logistic regression model for correct vital sign perception yielded an odds ratio (OR) of 1.88 (95% CI 1.41-2.52; P<.001) for individual instruction compared to class instruction as well as an OR of 3.03 (95% CI 2.50-3.70; P<.001) for the Visual Patient compared to conventional monitoring. Conclusions Although individual instruction on Visual Patient is slightly more effective, class instruction is a viable teaching method; thus, large-scale introduction of health care providers to this novel technology is feasible.

scholarly journals Comparing Classroom Instruction to Individual Instruction as an Approach to Teach Avatar-Based Patient Monitoring With Visual Patient: Simulation Study (Preprint)

2020 ◽  
Author(s):  
Julian Rössler ◽  
Alexander Kaserer ◽  
Benjamin Albiez ◽  
Julia Braun ◽  
Jan Breckwoldt ◽  
...  
Keyword(s):  
Large Scale ◽  
Patient Monitoring ◽  
Vital Signs ◽  
Care Providers ◽  
Instruction Group ◽  
Anesthesia Providers ◽  
Individual Instruction ◽  
Significant Difference ◽  
Historical Sample ◽  
Class Instruction

BACKGROUND Visual Patient is an avatar-based alternative to standard patient monitor displays that significantly improves the perception of vital signs. Implementation of this technology in larger organizations would require it to be teachable by brief class instruction to large groups of professionals. Therefore, our study aimed to investigate the efficacy of such a large-scale introduction to Visual Patient. OBJECTIVE In this study, we aimed to compare 2 different educational methods, one-on-one instruction and class instruction, for training anesthesia providers in avatar-based patient monitoring. METHODS We presented 42 anesthesia providers with 30 minutes of class instruction on Visual Patient (class instruction group). We further selected a historical sample of 16 participants from a previous study who each received individual instruction (individual instruction group). After the instruction, the participants were shown monitors with either conventional displays or Visual Patient displays and were asked to interpret vital signs. In the class instruction group, the participants were shown scenarios for either 3 or 10 seconds, and the numbers of correct perceptions with each technology were compared. Then, the teaching efficacy of the class instruction was compared with that of the individual instruction in the historical sample by 2-way mixed analysis of variance and mixed regression. RESULTS In the class instruction group, when participants were presented with the 3-second scenario, there was a statistically significant median increase in the number of perceived vital signs when the participants were shown the Visual Patient compared to when they were shown the conventional display (3 vital signs, <i>P</i>&lt;.001; effect size –0.55). No significant difference was found for the 10-second scenarios. There was a statistically significant interaction between the teaching intervention and display technology in the number of perceived vital signs (<i>P</i>=.04; partial η<sup>2</sup>=.076). The mixed logistic regression model for correct vital sign perception yielded an odds ratio (OR) of 1.88 (95% CI 1.41-2.52; <i>P</i>&lt;.001) for individual instruction compared to class instruction as well as an OR of 3.03 (95% CI 2.50-3.70; <i>P</i>&lt;.001) for the Visual Patient compared to conventional monitoring. CONCLUSIONS Although individual instruction on Visual Patient is slightly more effective, class instruction is a viable teaching method; thus, large-scale introduction of health care providers to this novel technology is feasible.

scholarly journals Continuous Remote Patient Monitoring Shows Early Cardiovascular Changes in COVID-19 Patients

2021 ◽  
Vol 10 (18) ◽  
pp. 4218
Author(s):  
Arik Eisenkraft ◽  
Yasmin Maor ◽  
Keren Constantini ◽  
Nir Goldstein ◽  
Dean Nachman ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Vital Signs ◽  
Final Analysis ◽  
Remote Patient Monitoring ◽  
Blood Oxygen Saturation ◽  
Respiratory Parameters ◽  
Significant Difference ◽  
Observational Cohort ◽  
Remote Patient ◽  
Worse Prognosis

COVID-19 exerts deleterious cardiopulmonary effects, leading to a worse prognosis in the most affected. This retrospective multi-center observational cohort study aimed to analyze the trajectories of key vitals amongst hospitalized COVID-19 patients using a chest-patch wearable providing continuous remote patient monitoring of numerous vital signs. The study was conducted in five COVID-19 isolation units. A total of 492 COVID-19 patients were included in the final analysis. Physiological parameters were measured every 15 min. More than 3 million measurements were collected including heart rate, systolic and diastolic blood pressure, cardiac output, cardiac index, systemic vascular resistance, respiratory rate, blood oxygen saturation, and body temperature. Cardiovascular deterioration appeared early after admission and in parallel with changes in the respiratory parameters, showing a significant difference in trajectories within sub-populations at high risk. Early detection of cardiovascular deterioration of COVID-19 patients is achievable when using frequent remote patient monitoring.

scholarly journals Relationship between documentation method and quality of chronic disease visit notes

2014 ◽  
Vol 05 (02) ◽  
pp. 480-490 ◽  
Author(s):  
L.A. Volk ◽  
S. Samaha ◽  
S.E. Pollard ◽  
D.H. Williams ◽  
J.M. Fiskio ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Vital Signs ◽  
Primary Care Providers ◽  
Subjective Quality ◽  
Free Form ◽  
Care Providers ◽  
Quality Ratings ◽  
Significant Difference

SummaryObjective: To assses the relationship between methods of documenting visit notes and note quality for primary care providers (PCPs) and specialists, and to determine the factors that contribute to higher quality notes for two chronic diseases.Methods: Retrospective chart review of visit notes at two academic medical centers. Two physicians rated the subjective quality of content areas of the note (vital signs, medications, lifestyle, labs, symptoms, assessment & plan), overall quality, and completed the 9 item Physician Documentation Quality Instrument (PDQI-9). We evaluated quality ratings in relation to the primary method of documentation (templates, free-form or dictation) for both PCPs and specialists. A one factor analysis of variance test was used to examine differences in mean quality scores among the methods.Results: A total of 112 physicians, 71 primary care physicians (PCP) and 41 specialists, wrote 240 notes. For specialists, templated notes had the highest overall quality scores (p≤0.001) while for PCPs, there was no statistically significant difference in overall quality score. For PCPs, free form received higher quality ratings on vital signs (p = 0.01), labs (p = 0.002), and lifestyle (p = 0.002) than other methods; templated notes had a higher rating on medications (p≤0.001). For specialists, templated notes received higher ratings on vital signs, labs, lifestyle and medications (p = 0.001).Discussion: There was no significant difference in subjective quality of visit notes written using free-form documentation, dictation or templates for PCPs. The subjective quality rating of templated notes was higher than that of dictated notes for specialists.Conclusion: As there is wide variation in physician documentation methods, and no significant difference in note quality between methods, recommending one approach for all physicians may not deliver optimal results.Citation: Neri PM, Volk LA, Samaha S, Pollard SE, Williams DH, Fiskio JM, Burdick E, Edwards ST, Ramelson H, Schiff GD, Bates DW. Relationship between documentation method and quality of chronic disease visit notes. Appl Clin Inf 2014; 5: 480–490 http://dx.doi.org/10.4338/ACI-2014-01-RA-0007

scholarly journals Anesthesia providers' visual attention in simulated anesthesia emergencies using conventional number-based and avatar-based patient monitoring: a prospective, eye-tracking study. (Preprint)

2021 ◽  
Author(s):  
Arsène Ljubenovic ◽  
Sadiq Said ◽  
Julia Braun ◽  
Bastian Grande ◽  
Michaela Kolbe ◽  
...  
Keyword(s):  
Visual Attention ◽  
Eye Tracking ◽  
Task Performance ◽  
Situation Awareness ◽  
Dwell Time ◽  
Patient Monitoring ◽  
Situational Awareness ◽  
Patient Monitor ◽  
Anesthesia Providers ◽  
Significant Difference

BACKGROUND Inadequate situational awareness accounts for two-thirds of preventable complications in anesthesia. An essential tool for situational awareness in the perioperative setting is the patient monitor. However, the conventional monitor has several weaknesses. Avatar-based patient monitoring may address these shortcomings and promote situation awareness, a prerequisite for good decision making. OBJECTIVE The spatial distribution of visual attention is a fundamental process for achieving adequate situation awareness and thus a potential quantifiable surrogate for situation awareness. Moreover, measuring visual attention with a head-mounted eye-tracker may provide insights into usage and acceptance of the new avatar-based patient monitoring modality. METHODS This prospective eye-tracking study compared anesthesia providers' visual attention on conventional and avatar-based patient monitors during simulated critical anesthesia events. We defined visual attention, measured as fixation count and dwell time, as our primary outcome. We correlated visual attention with the potential confounders: performance in managing simulated critical anesthesia events (task performance), work experience, and profession. We used mixed linear models to analyze the results. RESULTS Fifty-two teams performed 156 simulations. After a manual quality check of the eye-tracking footage, we excluded 57 simulations due to technical problems and quality issues. Participants had a median of 198 (IQR 92.5 – 317.5) fixations on the patient monitor with a median dwell time of 30.2 (IQR 14.9 – 51.3) seconds. We found no significant difference in participants' visual attention when using avatar-based patient monitoring or conventional patient monitoring. However, we found that with each percentage point of better task performance, the number of fixations decreased by about 1.39 (coefficient -1.39; 95%CI: -2.44 to -0.34; P=0.02), and the dwell time diminished by 0.23 seconds (coefficient -0.23; 95%CI: -0.4 to -0.06; P=0.01). CONCLUSIONS Using eye-tracking, we found no significant difference in visual attention when anesthesia providers used avatar-based monitoring or conventional patient monitoring in simulated critical anesthesia events. However, we identified visual attention in conjunction with task performance as a surrogate for situational awareness. CLINICALTRIAL Business Management System for Ethics Committees Number Req-2020-00059

Patient Monitoring Technology: Friend or Foe?

2000 ◽  
Vol 44 (26) ◽  
pp. 249-249
Author(s):  
F. Jacob Seagull ◽  
Yan Xiao
Keyword(s):  
Medical Device ◽  
Interface Design ◽  
Patient Monitoring ◽  
Vital Signs ◽  
Care Providers ◽  
Monitoring Technology ◽  
Object Based ◽  
Current Design ◽  
Device Manufacturer ◽  
State Of Affairs

This symposium presents four viewpoints on the role of patient monitoring technology in supporting care-provider activity in the medical domain. First, observations of care providers in the critical care setting provide an overview of the current state of affairs and the style of interaction that characterizes current technology. Second, task analysis and interface design techniques from a medical device manufacturer are reviewed as an example of how the medical device industry is incorporating human factors considerations into current design decisions. Third, an innovative approach using an ecological, object-based display is offered and systematic tests of its efficacy are presented as alternatives to traditional displays of vital signs for patient monitoring. Lastly, a strong critique of the current philosophy of monitoring technology is presented. The diverse viewpoints of the contributors provide evidence regarding the strengths, weaknesses and possibilities for improvement of patient monitoring technology.

scholarly journals The Mechanisms Responsible for Improved Information Transfer in Avatar-Based Patient Monitoring: Multicenter Comparative Eye-Tracking Study (Preprint)

2019 ◽  
Author(s):  
David Werner Tscholl ◽  
Julian Rössler ◽  
Lucas Handschin ◽  
Burkhardt Seifert ◽  
Donat R Spahn ◽  
...  
Keyword(s):  
Eye Tracking ◽  
Oxygen Saturation ◽  
Vital Sign ◽  
Skin Color ◽  
Information Transfer ◽  
Patient Monitoring ◽  
Vital Signs ◽  
Virtual Patient ◽  
Anesthesia Providers ◽  
Phi Coefficient

BACKGROUND Patient monitoring is central to perioperative and intensive care patient safety. Current state-of-the-art monitors display vital signs as numbers and waveforms. Visual Patient technology creates an easy-to-interpret virtual patient avatar model that displays vital sign information as it would look in a real-life patient (eg, avatar changes skin color from healthy to cyanotic depending on oxygen saturation). In previous studies, anesthesia providers using Visual Patient perceived more vital signs during short glances than with conventional monitoring. OBJECTIVE We aimed to study the deeper mechanisms underlying information perception in conventional and avatar-based monitoring. METHODS In this prospective, multicenter study with a within-subject design, we showed 32 anesthesia providers four 3- and 10-second monitoring scenarios alternatingly as either routine conventional or avatar-based in random sequence. All participants observed the same scenarios with both technologies and reported the vital sign status after each scenario. Using eye-tracking, we evaluated which vital signs the participants had visually fixated (ie, could have potentially read and perceived) during a scenario. We compared the frequencies and durations of participants’ visual fixations of vital signs between the two technologies. RESULTS Participants visually fixated more vital signs per scenario in avatar-based monitoring (median 10, IQR 9-11 versus median 6, IQR 4-8, <i>P</i>&lt;.001; median of differences=3, 95% CI 3-4). In multivariable linear regression, monitoring technology (conventional versus avatar-based monitoring, difference=−3.3, <i>P</i>&lt;.001) was an independent predictor of the number of visually fixated vital signs. The difference was less prominent in the longer (10-second) scenarios (difference=−1.5, <i>P</i>=.04). Study center, profession, gender, and scenario order did not influence the differences between methods. In all four scenarios, the participants visually fixated 9 of 11 vital signs statistically significantly longer using the avatar (all <i>P</i>&lt;.001). Four critical vital signs (pulse rate, blood pressure, oxygen saturation, and respiratory rate) were visible almost the entire time of a scenario with the avatar; these were only visible for fractions of the observations with conventional monitoring. Visual fixation of a certain vital sign was associated with the correct perception of that vital sign in both technologies (avatar: phi coefficient=0.358; conventional monitoring: phi coefficient=0.515, both <i>P</i>&lt;.001). CONCLUSIONS This eye-tracking study uncovered that the way the avatar-based technology integrates the vital sign information into a virtual patient model enabled parallel perception of multiple vital signs and was responsible for the improved information transfer. For example, a single look at the avatar’s body can provide information about: pulse rate (pulsation frequency), blood pressure (pulsation intensity), oxygen saturation (skin color), neuromuscular relaxation (extremities limp or stiff), and body temperature (heatwaves or ice crystals). This study adds a new and higher level of empirical evidence about why avatar-based monitoring improves vital sign perception compared with conventional monitoring.

scholarly journals The Mechanisms Responsible for Improved Information Transfer in Avatar-Based Patient Monitoring: Multicenter Comparative Eye-Tracking Study

10.2196/15070 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e15070 ◽  
Author(s):  
David Werner Tscholl ◽  
Julian Rössler ◽  
Lucas Handschin ◽  
Burkhardt Seifert ◽  
Donat R Spahn ◽  
...  
Keyword(s):  
Eye Tracking ◽  
Oxygen Saturation ◽  
Vital Sign ◽  
Skin Color ◽  
Information Transfer ◽  
Patient Monitoring ◽  
Vital Signs ◽  
Virtual Patient ◽  
Anesthesia Providers ◽  
Phi Coefficient

Background Patient monitoring is central to perioperative and intensive care patient safety. Current state-of-the-art monitors display vital signs as numbers and waveforms. Visual Patient technology creates an easy-to-interpret virtual patient avatar model that displays vital sign information as it would look in a real-life patient (eg, avatar changes skin color from healthy to cyanotic depending on oxygen saturation). In previous studies, anesthesia providers using Visual Patient perceived more vital signs during short glances than with conventional monitoring. Objective We aimed to study the deeper mechanisms underlying information perception in conventional and avatar-based monitoring. Methods In this prospective, multicenter study with a within-subject design, we showed 32 anesthesia providers four 3- and 10-second monitoring scenarios alternatingly as either routine conventional or avatar-based in random sequence. All participants observed the same scenarios with both technologies and reported the vital sign status after each scenario. Using eye-tracking, we evaluated which vital signs the participants had visually fixated (ie, could have potentially read and perceived) during a scenario. We compared the frequencies and durations of participants’ visual fixations of vital signs between the two technologies. Results Participants visually fixated more vital signs per scenario in avatar-based monitoring (median 10, IQR 9-11 versus median 6, IQR 4-8, P<.001; median of differences=3, 95% CI 3-4). In multivariable linear regression, monitoring technology (conventional versus avatar-based monitoring, difference=−3.3, P<.001) was an independent predictor of the number of visually fixated vital signs. The difference was less prominent in the longer (10-second) scenarios (difference=−1.5, P=.04). Study center, profession, gender, and scenario order did not influence the differences between methods. In all four scenarios, the participants visually fixated 9 of 11 vital signs statistically significantly longer using the avatar (all P<.001). Four critical vital signs (pulse rate, blood pressure, oxygen saturation, and respiratory rate) were visible almost the entire time of a scenario with the avatar; these were only visible for fractions of the observations with conventional monitoring. Visual fixation of a certain vital sign was associated with the correct perception of that vital sign in both technologies (avatar: phi coefficient=0.358; conventional monitoring: phi coefficient=0.515, both P<.001). Conclusions This eye-tracking study uncovered that the way the avatar-based technology integrates the vital sign information into a virtual patient model enabled parallel perception of multiple vital signs and was responsible for the improved information transfer. For example, a single look at the avatar’s body can provide information about: pulse rate (pulsation frequency), blood pressure (pulsation intensity), oxygen saturation (skin color), neuromuscular relaxation (extremities limp or stiff), and body temperature (heatwaves or ice crystals). This study adds a new and higher level of empirical evidence about why avatar-based monitoring improves vital sign perception compared with conventional monitoring.

Implementation of a Cyber-Physical System Using Wireless Sensor Networks for Monitoring Patients

2015 ◽  
Vol 1 ◽  
pp. 26 ◽  
Author(s):  
Vo Que Son ◽  
Do Tan A
Keyword(s):  
Wireless Sensor Networks ◽  
Sensor Networks ◽  
Physical System ◽  
Patient Monitoring ◽  
High Reliability ◽  
Vital Signs ◽  
Wireless Sensor ◽  
Cyber Physical System ◽  
Self Administration ◽  
Hospital Units

Sensing, distributed computation and wireless communication are the essential building components of a Cyber-Physical System (CPS). Having many advantages such as mobility, low power, multi-hop routing, low latency, self-administration, utonomous data acquisition, and fault tolerance, Wireless Sensor Networks (WSNs) have gone beyond the scope of monitoring the environment and can be a way to support CPS. This paper presents the design, deployment, and empirical study of an eHealth system, which can remotely monitor vital signs from patients such as body temperature, blood pressure, SPO2, and heart rate. The primary contribution of this paper is the measurements of the proposed eHealth device that assesses the feasibility of WSNs for patient monitoring in hospitals in two aspects of communication and clinical sensing. Moreover, both simulation and experiment are used to investigate the performance of the design in many aspects such as networking reliability, sensing reliability, or end-to-end delay. The results show that the network achieved high reliability - nearly 97% while the sensing reliability of the vital signs can be obtained at approximately 98%. This indicates the feasibility and promise of using WSNs for continuous patient monitoring and clinical worsening detection in general hospital units.

scholarly journals Optimizing Manufacturing and Osseointegration of Ti6Al4V Implants through Precision Casting and Calcium and Phosphorus Ion Implantation? In Vivo Results of a Large-Scale Animal Trial

Materials ◽  
2020 ◽  
Vol 13 (7) ◽  
pp. 1670 ◽  
Author(s):  
Wölfle-Roos JV ◽  
Katmer Amet B ◽  
Fiedler J ◽  
Michels H ◽  
Kappelt G ◽  
...  
Keyword(s):  
Ion Implantation ◽  
Large Scale ◽  
In Vivo Studies ◽  
Control Group ◽  
Implant Surface ◽  
Precision Casting ◽  
Pull Out ◽  
Significant Difference ◽  
Calcium And Phosphorus

Background: Uncemented implants are still associated with several major challenges, especially with regard to their manufacturing and their osseointegration. In this study, a novel manufacturing technique—an optimized form of precision casting—and a novel surface modification to promote osseointegration—calcium and phosphorus ion implantation into the implant surface—were tested in vivo. Methods: Cylindrical Ti6Al4V implants were inserted bilaterally into the tibia of 110 rats. We compared two generations of cast Ti6Al4V implants (CAST 1st GEN, n = 22, and CAST 2nd GEN, n = 22) as well as cast 2nd GEN Ti6Al4V implants with calcium (CAST + CA, n = 22) and phosphorus (CAST + P, n = 22) ion implantation to standard machined Ti6Al4V implants (control, n = 22). After 4 and 12 weeks, maximal pull-out force and bone-to-implant contact rate (BIC) were measured and compared between all five groups. Results: There was no significant difference between all five groups after 4 weeks or 12 weeks with regard to pull-out force (p > 0.05, Kruskal Wallis test). Histomorphometric analysis showed no significant difference of BIC after 4 weeks (p > 0.05, Kruskal–Wallis test), whereas there was a trend towards a higher BIC in the CAST + P group (54.8% ± 15.2%), especially compared to the control group (38.6% ± 12.8%) after 12 weeks (p = 0.053, Kruskal–Wallis test). Conclusion: In this study, we found no indication of inferiority of Ti6Al4V implants cast with the optimized centrifugal precision casting technique of the second generation compared to standard Ti6Al4V implants. As the employed manufacturing process holds considerable economic potential, mainly due to a significantly decreased material demand per implant by casting near net-shape instead of milling away most of the starting ingot, its application in manufacturing uncemented implants seems promising. However, no significant advantages of calcium or phosphorus ion implantation could be observed in this study. Due to the promising results of ion implantation in previous in vitro and in vivo studies, further in vivo studies with different ion implantation conditions should be considered.

scholarly journals Longitudinal remotely mentored self-performed lung ultrasound surveillance of paucisymptomatic Covid-19 patients at risk of disease progression

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Andrew W. Kirkpatrick ◽  
Jessica L. McKee ◽  
John M. Conly
Keyword(s):  
At Risk ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Human Life ◽  
Vital Signs ◽  
Home Monitoring ◽  
Cost Effective ◽  
Care Providers ◽  
Vital Signs Monitoring ◽  
Ultrasound Probes

AbstractCOVID-19 has impacted human life globally and threatens to overwhelm health-care resources. Infection rates are rapidly rising almost everywhere, and new approaches are required to both prevent transmission, but to also monitor and rescue infected and at-risk patients from severe complications. Point-of-care lung ultrasound has received intense attention as a cost-effective technology that can aid early diagnosis, triage, and longitudinal follow-up of lung health. Detecting pleural abnormalities in previously healthy lungs reveal the beginning of lung inflammation eventually requiring mechanical ventilation with sensitivities superior to chest radiographs or oxygen saturation monitoring. Using a paradigm first developed for space-medicine known as Remotely Telementored Self-Performed Ultrasound (RTSPUS), motivated patients with portable smartphone support ultrasound probes can be guided completely remotely by a remote lung imaging expert to longitudinally follow the health of their own lungs. Ultrasound probes can be couriered or even delivered by drone and can be easily sterilized or dedicated to one or a commonly exposed cohort of individuals. Using medical outreach supported by remote vital signs monitoring and lung ultrasound health surveillance would allow clinicians to follow and virtually lay hands upon many at-risk paucisymptomatic patients. Our initial experiences with such patients are presented, and we believe present a paradigm for an evolution in rich home-monitoring of the many patients expected to become infected and who threaten to overwhelm resources if they must all be assessed in person by at-risk care providers.

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