Remote Patient Monitoring Program for Hospital Discharged COVID-19 Patients

被引:76
|
作者
Gordon, William J. [1 ,2 ,3 ]
Henderson, Daniel [3 ,4 ]
DeSharone, Avital [4 ]
Fisher, Herrick N. [1 ,3 ]
Judge, Jessica [1 ]
Levine, David M. [1 ,3 ]
MacLean, Laura [5 ]
Sousa, Diane [5 ]
Su, Mack Y. [3 ]
Boxer, Robert [1 ,3 ]
机构
[1] Brigham & Womens Hosp, Div Gen Internal Med, Boston, MA USA
[2] Harvard Med Sch, Dept Med, Boston, MA USA
[3] Harvard Med Sch, Boston, MA 02115 USA
[4] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA
[5] Brigham & Womens Hosp, Boston, MA 02115 USA
来源
APPLIED CLINICAL INFORMATICS | 2020年 / 11卷 / 05期
关键词
remote patient monitoring; coronavirus disease 2019; patient outcome assessment; remote sensing technology; CHRONIC HEART-FAILURE; DEVICE DATA; MANAGEMENT; OUTCOMES; IMPACT;
D O I
10.1055/s-0040-1721039
中图分类号
R-058 [];
学科分类号
摘要
Objective We deployed a Remote Patient Monitoring (RPM) program to monitor patients with coronavirus disease 2019 (COVID-19) upon hospital discharge. We describe the patient characteristics, program characteristics, and clinical outcomes of patients in our RPM program. Methods We enrolled COVID-19 patients being discharged home from the hospital. Enrolled patients had an app, and were provided with a pulse oximeter and thermometer. Patients self-reported symptoms, O (2) saturation, and temperature daily. Abnormal symptoms or vital signs were flagged and assessed by a pool of nurses. Descriptive statistics were used to describe patient and program characteristics. A mixed-effects logistic regression model was used to determine the odds of a combined endpoint of emergency department (ED) or hospital readmission. Results A total of 295 patients were referred for RPM from five participating hospitals, and 225 patients were enrolled. A majority of enrolled patients (66%) completed the monitoring period without triggering an abnormal alert. Enrollment was associated with a decreased odds of ED or hospital readmission (adjusted odds ratio: 0.54; 95% confidence interval: 0.3-0.97; p =0.039). Referral without enrollment was not associated with a reduced odds of ED or hospital readmission. Conclusion RPM for COVID-19 provides a mechanism to monitor patients in their home environment and reduce hospital utilization. Our work suggests that RPM reduces readmissions for patients with COVID-19 and provides scalable remote monitoring capabilities upon hospital discharge. RPM for postdischarge patients with COVID-19 was associated with a decreased risk of readmission to the ED or hospital, and provided a scalable mechanism to monitor patients in their home environment.
引用
收藏
页码:792 / 801
页数:10
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