Cape Town hospital goes paperless to reduce Covid-19 transmissions

As the Western Cape approaches its Covid-19 infection peak, the province’s biggest hospital, Tygerberg, has ditched its paper-based patient folders for voice and electronic notes.

This in an effort to reduce transmission of the respiratory diseases among healthcare workers.

An ambitious digitisation project of the hospital’s Covid-19 intensive care unit will not only improve the care of seriously ill Covid-19 patients and reduce infection among healthcare workers, but the installation of cameras could potentially allow stable patients to have video calls with their families.

The use of cameras and tablets will not only replace the manual capturing of patient records, but it will also be used to monitor patients’ vitals.

This is the second hospital in the Western Cape that will be going paperless in its Covid-19 units. The new Covid-19 field hospital at the Cape Town International Convention Centre was the first to go paperless when it opened its doors in mid-June.

Prof Jimmy Volmink, Stellenbosch University's dean of medicine and health sciences, said the new system - a joint project the university and the Western Cape health department - would “contribute to improved care for patients with Covid-19 as well as a safer working environment for healthcare workers in the ICU environment”. 

Volmink said the multimillion-rand investment, which has been made possible by a grant from the Michael & Susan Dell Foundation, “will be felt long after the current pandemic has abated”.

Tygerberg was the first designated Covid-19 hospital in the Western Cape, and is presently dealing with a high service load of infections, including patients needing critical care. It services the ICU needs of district and regional hospitals including Paarl, Khayelitsha, Helderberg and Worcester hospitals.

The hospital also has the highest number of infections among healthcare workers, with over 300 from that hospital having tested positive for Covid-19.

Hospital CEO Dr Dimitri Erasmus said using paper-based folders in a labour-intensive Covid-19 ICU posed potential risk of infection workers at the patients’ bedside.

“This technology will further enable us to reduce the risks to staff members working in the critical care environment, and it is a significant step forward,” he said.

Ventilation of Covid-19 patients required specialised knowledge of ventilation physiology and critical care experience. At Tygerberg this was only held by a small number of intensive care specialists, otherwise known as intensivists.

Prof Nico Gey van Pittius, vice-dean at Stellenbosch University’s faculty of medicine and health sciences, said: “With the impending surge of Covid-19 cases, resources will undoubtedly be under huge pressure - and clinicians and nursing staff will face an increased risk of infection.”

That hospital recently acquired two "infection-resistant robot nurses" - called Quintin and Salma - who are already assisting intensivists with ward rounds in the Covid-19 ICU. The digitisation project will be an expansion of Quintin and Salma’s work and will further decrease the risk of contamination and infection, while also increasing capacity, and effectiveness of medical and nursing staff.

Dr Brian Allwood, an intensivist at Tygerberg Hospital, said even though hospital staff were always geared with full personal protective equipment (PPE), “it is only comfortable to wear for up to 45 minutes”.

“It is cumbersome to put on and to remove, and thus takes up time. In reducing paperwork, nursing capacity will be freed up to focus on providing high-quality nursing care to patients,” he said.

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