Background: Patients affected by the COVID-19 pandemic required physical/social isolation due to the transmissibility of SARs CoV-2; those hospitalized in healthcare facilities often suffered loneliness due to a complete separation from their loved ones through visitor restrictions.(1) Human contact and movement were restricted to contain the spread of disease. When this kind of restriction must be employed, the “Guidance for Managing Ethical Issues in Infectious Disease Outbreaks”, states that it is necessary to provide people with “effective alternative communication strategies”. (2) Methods:  This is an observational descriptive study that uses qualitative variables to analyze information obtained by virtual focus groups consisting of either medical professionals or family members of hospitalized patients in the ICU of the Eugenio Espejo Hospital (EEH) in Quito, Ecuador. Each video call allowed us to assess anonymous opinions concerning communication methods utilized during the delivery of daily clinical updates in the ICU. By focusing on a patient-and family-centered model, this study aims to minimize the impact of social isolation in hospitalized patients through the implementation of regular doctor-led video conference calls with family members, as well as video calls between the patient and family members when feasible.(1) Results: This study evaluates the increased satisfaction of family members and medical professionals with the implementation of video calls when compared to traditional telephone calls. A contrast between the time before implementing the telehealth team and the time afterward was observed in at least five positive characteristics: 1) the general telehealth experience, 2) the clarity of the messages, 3) the quality of care, 4) the sense of comfort, and 5) the improvement of communication. Conclusions: There was a positive effect on communication quality for both family members and medical professionals, increasing their satisfaction in terms of finding new methods to reduce the social isolation enforced by the current pandemic. Nevertheless, the future role of virtual communication remains undefined as we return to individualized face-to-face meetings.  

I few years ago, I coined the term, “Medicine Without Walls”1 to describe our future healthcare delivery system—an environment where patient and healthcare practitioner are unencumbered by physical location or limitations in access points due to human resource restrictions, where medical information is transferred not only between patient and clinician but also between any number of care practitioners and healthcare institutions—a world where patients have open and ready access to medical care when and where needed.

Due to the armed conflict in the East of Ukraine, it is relevant to investigate factors that affect patient outcomes with the use of telemedicine. This applies especially to patients with multiple gunshot fractures, which is the most severe category at increased risk for complications and unsatisfactory results. A case study is reported here.