Protecting the public’s health during a worldwide pandemic is prompting health agencies to revisit and revise many daily practices. Even while local environmental health professionals are assisting with the COVID-19 response—either through running testing centers, answering public concerns, or educating permit holders—the same environmental health responsibilities remain. Plan review, inspections, complaint investigations, renewals, fee collection, etc. continue in some form or will again soon.
By many estimates, numerous industries will experience five or more years of digital innovation in the first year of the COVID-19 pandemic. This estimate means to me that what was once a “nice to have” is now an imperative. An easy example is the schools that had to pivot to an online curriculum in just weeks. Telemedicine is another example.
When the National Environmental Health Association (NEHA) advertised a new offering—Virtual Inspections During COVID-19 Pandemic—through its COVID-19: Essential Functions of the Environmental Health Workforce Live Chat Series that promised a practical study of virtual inspections, I signed up immediately and marked my calendar. I was not disappointed.
What once seemed impossible, such as conducting an inspection without actually being in the facility, is actually being done in the field. And the practice, with realistic expectations, may even continue after the virus is no longer a threat. Why is that? It has everything to do with reduced budgets and shifting expectations.
Laura Wildey, NEHA senior program analyst in food safety, explained that NEHA was receiving a lot of questions about virtual inspections and whether or not other jurisdictions were having success. “Through this live chat series offering, we worked to connect those jurisdictions to avoid recreating the wheel,” stated Wildey. The virtual inspection live chat series featured five active agencies, each with either statewide or local environmental health responsibilities.
A virtual inspection connects the inspector in the office with the facility operator via phone, computer, or tablet to talk with each other and to see the layout and operations of the facility.
Interestingly, there are many options out there. Mentioned in the webinar were FaceTime (limited to Apple devices), Google Duo, Google Hangouts, Zoom, Skype, Microsoft Teams, and Webex. Most of the software programs are free for voice and video, although other capabilities (like recording to the cloud) vary.
What software should you use? There were two essential considerations: 1) is the software compatible with the inspector and operator equipment? and 2) is the software familiar to the participants? Ask and then try to use the app that is already on the operator’s phone.
How Does It Work?
Most recommended was an early invitation with written instructions that explained what was being proposed. Most operators really appreciated the opportunity to move their projects forward.
Schedule an advance meeting to check out the software, sound quality, video quality, and Wi-Fi. Request an orientation (i.e., visual tour) of the facility, which gives everybody some practice and boosts confidence. It is also important to realize that a virtual inspection is not always possible and you should have a plan B.
Set an appointment and be sure to include the specifics for the chosen software. FaceTime, for example, just needs a phone number. For other software, exchange the username or meeting link in advance.
At the agreed upon date and time, connect with the facility operator and begin the inspection.
You Don’t Know What You Don’t Know
The NEHA live chat series was great because practitioners described their own recent results and anecdotes. What emerged was invaluable! Here are a few key takeaways
• Begin with the written instructions for operators and procedures for inspectors from other successful agencies.
• Ask the operator to have an assistant hold and point the camera. The assistant must be able to follow instructions such as move left, move up, get closer, and back away. The operator must hear and answer questions.
• Remember that a virtual inspection could have more than two parties. A corporate representative, trainee, or translator might
join the inspection.
• Start at the facility entrance and ask for a walk-through. Work clockwise in each area to assure coverage.
• Ask the operator to use a digital thermometer as it is easier to read on a video screen.
• Create a new inspection type in your inspection software to differentiate between a virtual inspection and an in-person inspection.
• Have realistic expectations and budget for breaks as this work can be tiring.
Concerns and Questions
The environmental health professionals that attended the live chat series had some questions that are important to note.
Question: Does a virtual inspection meet the legal obligations of the agency?
Answer: In some cases, no. In other cases, it is uncertain. Some agencies sought a legal opinion. Others planned to conduct an inperson inspection as soon as possible.
Question: How can a signature be captured?
Answer: Some jurisdictions e-mailed the inspection report with instructions to print, sign, and return the report.
Others simply annotated the inspection record, indicating that the operator confirmed receipt verbally.
Question: Did the agency attempt to record the inspection audio and video?
Answer: It might be valuable to “screen grab” static images or to save the entire recording to the cloud. In most cases, however, the agencies did not attempt a recording of the entire inspection. As mentioned before, not every app has this capability.
Question: Did the virtual inspection take more time?
Answer: The panel cited examples of both longer and shorter inspections.
Question: Will the agencies continue with virtual inspections after COVID-19 restrictions lift?
Answer: The panel gave a mixed reply. Some said no. Others explained that the practice might continue, especially in rural areas served by the state where travel can be prohibitive.
Considering Your Own Pilot?
First, navigate to NEHA’s COVID-19: Essential Functions of the Environmental Health Workforce Live Chat Series web page at
https://emergency-neha.org/covid19/livechat-series and watch the recording of the Virtual Inspections During COVID-19 Pandemic live chat.
Second, bookmark and visit https://emergency-neha.org/covid19/, a late-breaking resource for environmental health professionals. The written procedures published by the panelists were extremely useful.
Finally, think about proposing a pilot of your own. If not virtual inspections, then for other service areas. There might never be a better time.
This article was originally published in NEHA’S Journal of Environmental Health: https://www.neha.org/sites/default/files/jeh/JEH9.20-Column-Building-Capacity.pdf