Novel Technology Deployed for Remote Ventilator Management by Respiratory Therapists During the COVID-19 Pandemic: Lessons Learned.

A novel remote ventilator management (control) technology (Omnitool) was implemented for use with ICU patients during the COVID-19 pandemic to mitigate in-person respiratory therapist interactions and preserve personal protective equipment. In the latter half of 2020, eight mechanical ventilators were purchased and enabled for Omnitool deployment through the application of a vendor software option. Subsequently, these ventilators were outfitted with commercially available informatics hardware that permitted remote communication and management via the existing hospital network. In total, 17 patients with COVID-19 respiratory failure were placed on Omnitool enabled ventilators between January 1, 2021-April 30, 2021. The median Omnitool use days was 10. Deployment of a novel remote ventilator management technology is feasible; however, further study is needed to simplify the set up and utilization of the system. Future demands for remote ventilator management are predictable, whether in rural areas, military scenarios without adequate RT staffing, or in circumstances with new and easily transmissible toxic infections, and will continue to encourage the development of relatively easy to apply informatics-based solutions. Herein we share five lessons learned from our Omnitool deployment.

Asynchronous automated electronic laboratory result notifications: a systematic review.

OBJECTIVE: To systematically review the literature pertaining to asynchronous automated electronic notifications of laboratory results to clinicians. METHODS: PubMed, Web of Science, and the Cochrane Collaboration were queried for studies pertaining to automated electronic notifications of laboratory results. A title review was performed on the primary results, with a further abstract review and full review to produce the final set of included articles. RESULTS: The full review included 34 articles, representing 19 institutions. Of these, 19 reported implementation and design of systems, 11 reported quasi-experimental studies, 3 reported a randomized controlled trial, and 1 was a meta-analysis. Twenty-seven articles included alerts of critical results, while 5 focused on urgent notifications and 2 on elective notifications. There was considerable variability in clinical setting, system implementation, and results presented. CONCLUSION: Several asynchronous automated electronic notification systems for laboratory results have been evaluated, most from >10 years ago. Further research on the effect of notifications on clinicians as well as the use of modern electronic health records and new methods of notification is warranted to determine their effects on workflow and clinical outcomes.

Factors influencing scholarly impact: does urology fellowship training affect research output?

PURPOSE: Residents seek postresidency fellowship training to increase competency with novel surgical techniques and augment their fund of knowledge. Research productivity is a vital component of advancement in academic urology. Our objectives were to use the h-index (an objective and readily available bibliometric that has been repeatedly shown to correlate with scholarly impact, funding procurement, and academic promotion in urology as well as other specialties) to determine whether any relationship exists between fellowship training and scholarly impact among academic urologists. Additional examination was performed to determine whether any differences in scholarly influence are present among practitioners in the major urologic subspecialties. MATERIALS AND METHODS: Overall, 851 faculty members from 101 academic urology departments were organized by academic rank and fellowship completed. Research productivity was calculated using the h-index, calculated from the Scopus database. RESULTS: There was no statistical difference in h-index found between fellowship-trained and nonfellowship-trained academic urologists. The highest h-indices were seen among urologic oncologists (18.1 ± 0.95) and nonfellowship-trained urologists (14.62 ± 0.80). Nearly 70% of department chairs included in this analysis were urologic oncologists or general urologists. CONCLUSIONS: No difference in h-index existed between fellowship-trained and nonfellowship-trained urologists, although practitioners in the subspecialty cohorts with the highest research productivity (nonfellowship-trained and urologic oncologists) comprised 70% of department chairpersons. This relationship suggests that a strong research profile is highly valued during selection for academic promotion. Differences existed on further comparison by subspecialty. Fellowship training may represent another potential opportunity to introduce structured research experiences for trainees.