A University of Iowa study published this month in the Journal of Telemedicine and Telecare found that an at-home telemonitoring program was an effective and sustainable way to manage COVID-19 for patients.
The goals of the program, as outlined in the study, were to avoid unnecessary hospitalizations, identify declining patients, escalate care when needed and provide support to patients and families.
“Despite the low intensity of the intervention, our results support the use of telehealth to effectively monitor patients with COVID-19 at home,” wrote researchers.
WHY IT MATTERS
As researchers explained, 1,128 University of Iowa Hospitals and Clinics patients who had been diagnosed with COVID-19 met the criteria for the home monitoring program, known as HMP.
Enrolled patients were risk-stratified based on age and underlying comorbidities.
High-risk patients were given a monitoring kit including a pulse oximeter, an automated blood pressure cuff, vital signs and symptoms log sheet, contact information to report worsening symptoms and instructions in English, Spanish and French.
A call line was established for patients to use outside of regular business hours, and patients were instructed to call if they developed oxygen saturation under 92%, new shortness of breath, decrease in systolic blood pressure or other worsening symptoms.
Most patients, researchers found, did well with the system. Only 6.2% required hospitalization, and 1.2% a stay in the intensive care unit, from the time of HMP enrollment. One patient died while being monitored, having presented to an emergency department beforehand.
Hospitalizations were much more frequent for high-risk patients.
“Our observed rates of hospitalization and mortality were very low compared with national and regional averages at the time of this study,” said researchers.
Although the patient population was racially and ethnically diverse, the study team noted that the mean patient age was lower than what is described in similar studies, and the majority of patients had zero or one risk factors for severe illness.
“It is not clear whether similar interventions would be sufficient in these settings where the rate of patient adverse outcomes would be much higher,” said the study.
THE LARGER TREND
Health systems have been strategizing throughout the pandemic about the best ways to keep patients out of the hospital, given COVID-19’s strain on resources.
Research published in December 2020 found that remote patient monitoring capabilities contributed to favorable COVID-19 patient outcomes at the Mayo Clinic, for instance.
But the potential for RPM goes beyond acute conditions. For instance, Dr. Waqaas Al-Siddiq, chairman, CEO and founder of Biotricity, told Healthcare IT News earlier this month that telehealth can help patients with chronic disease as well.
“When you have a chronic condition, you need to maintain contact with providers to stay on track. And the added stress of living in a pandemic is enough to worsen a chronic condition, which has been reported. Patients need more care, not less,” said Al-Siddiq.
ON THE RECORD
“This study highlights a novel method of providing healthcare in a technology-driven world, reducing the utilization of hospital resources, while also allowing timely identification of disease progression and rapid escalation to inpatient care when necessary,” said the University of Iowa researchers.
“It is also important to know that, in the event of a future pandemic, we have a tested method of risk-assessing patients and providing healthcare while minimizing healthcare worker exposures,” they said.
Kat Jercich is senior editor of Healthcare IT News.
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.
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