Table 1.

Changes in University of Pennsylvania Health System Telemedicine Functions to Address Infection Control Before and During the COVID-19 Pandemic

	Prepandemic	During pandemic
Outpatient virtual visits	Telemedicine used for outpatient visits in limited role with <100 visits per day. Videoconferencing using on-premise server-based technology with limited capacity for expansion.	Conversion of most outpatient visits to telemedicine to avoid potential exposures in hospital clinic environment. Videoconferencing changed to cloud-based platform. Support through command center.
Inpatient teleconsultations	Inpatient teleconsults in selected areas including telestroke and critical care.	Deployment of iPads on stands throughout Penn hospitals to allow providers and staff to reduce exposures and conserve personal protective equipment. Access to all devices including patient's personal phones from proprietary Penn Medicine Switchboard application developed at University of Pennsylvania Health System.
Penn Medicine OnDemand	Service available primarily to faculty, staff, and students through MyChart portal.	Expanded availability by increasing staffing to accommodate dramatic increase in volume and to limit need for in-person evaluations at emergency departments, urgent care, or outpatient offices. Continued to utilize MyChart portal.
Penn Medicine at Home	Monitoring of selected patients at home with visits by home health care staff.	Applied home monitoring to COVID-19 patients with mild-to-moderate disease capable of management at home with remote monitoring to maintain availability of hospital beds for more severe patients with respiratory distress.