Telemedicine via Smart Glasses in Critical Care of the Neurosurgical Patient – A COVID-19 Pandemic Preparedness and Response in Neurosurgery

Munusamy, Thangaraj; Karuppiah, Ravindran; Faizal A Bahuri, Nor; Sockalingam, Sutharshan; Cham, Chun Yoong; Waran, Vicknes

Objective The COVID-19 pandemic poses major risks to healthcare workers in neurocritical care. Recommendations are in place to limit medical personnel attending to the neurosurgical patient as a protective measure and to conserve personal protective equipment. However, the complexity of the neurosurgical patient proves to be a challenge and an opportunity for innovation. The goal of our study was to determine if telemedicine delivered through smart glasses was feasible and effective in an alternative method of conducting ward round on neurocritical care patients during the pandemic. Methods A random pair of Neurosurgery resident and specialist conducted consecutive virtual and physical ward rounds on neurocritical patients. A virtual ward round was first conducted remotely by a specialist who received real-time audiovisual information from a resident wearing smart glasses integrated with telemedicine. Subsequently, a physical ward round was performed together by the resident and specialist on the same patient. The management plans of both ward rounds were compared and the intrarater reliability was measured. On study completion a qualitative survey was performed. Results Ten paired ward rounds were performed on 103 neurocritical care patients with excellent overall intrarater reliability. Nine out of ten showed good to excellent internal consistency and one showed acceptable internal consistency. Qualitative analysis indicated wide user acceptance and high satisfaction rate with the alternative method. Conclusions Virtual ward rounds using telemedicine via smart glasses on neurosurgical patients in critical care were feasible, effective and widely accepted as an alternative to physical ward rounds during the COVID-19 pandemic.