An Implementation Roadmap for Establishing Remote Infectious Disease Specialist Support for Consultation and Antibiotic Stewardship in Resource-Limited Settings

Daniel J. Livorsi*, Rima Abdel-Massih, Christopher J. Crnich, Elizabeth S. Dodds-Ashley, Charlesnika T. Evans, Cassie Cunningham Goedken, Kelly L. Echevarria, Allison A. Kelly, S. Shaefer Spires, John J. Veillette, Todd J. Vento, Robin L.P. Jump

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

Infectious Disease (ID)-trained specialists, defined as ID pharmacists and ID physicians, improve hospital care by providing consultations to patients with complicated infections and by leading programs that monitor and improve antibiotic prescribing. However, many hospitals and nursing homes lack access to ID specialists. Telehealth is an effective tool to deliver ID specialist expertise to resource-limited settings. Telehealth services are most useful when they are adapted to meet the needs and resources of the local setting. In this step-by-step guide, we describe how a tailored telehealth program can be implemented to provide remote ID specialist support for direct patient consultation and to support local antibiotic stewardship activities. We outline 3 major phases of putting a telehealth program into effect: pre-implementation, implementation, and sustainment. To increase the likelihood of success, we recommend actively involving local leadership and other stakeholders in all aspects of developing, implementing, measuring, and refining programmatic activities.

Original languageEnglish (US)
Article numberofac588
JournalOpen Forum Infectious Diseases
Volume9
Issue number12
DOIs
StatePublished - Dec 1 2022

Funding

Potential conflicts of interest. R.A. is the co-founder, Chief Medical Officer, and Shareholder at Infectious Disease Connect, Inc. R.J. is the Principal Investigator on research grants from Pfizer and Merck; she has also participated in advisory boards for Pfizer. D.J.L. has received research funding from Merck. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Keywords

  • antibiotic stewardship
  • infectious disease consultation
  • rural hospitals
  • telemedicine

ASJC Scopus subject areas

  • Infectious Diseases
  • Oncology

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