Building a Real-Time Remote Patient Monitoring Patient Safety Program for COVID-19 Patients

Abstract

Coronavirus disease 2019 (COVID-19) pandemic has forced providers to rapidly adopt telehealth tools to reduce staff exposure to ill persons, preserve personal protective equipment, and minimize impact of patient surges on facilities. Remote patient monitoring (RPM) can be used to monitor high-risk patients from their homes and open up hospital bed availability. The authors describe a pilot program to evaluate the impact of RPM in postdischarge monitoring of COVID-19 patients. High-risk patients discharging from the hospital received a wearable vital sign monitoring device to be worn for 8 consecutive days, allowing real-time data transmission to a virtual health center (VHC), which had been established prior to the pandemic, via a smart phone application. The data were monitored 24 hours a day by a VHC tech with built-in escalation protocols to a nurse and/or an attending physician if needed. Eighty patients were enrolled, 48% women with an age range of 19-83 years. Languages included Spanish (49%), English (47%), Burmese (2%), and Swahili (1%). The most common comorbidities included hypertension (48%) and diabetes mellitus (48%). Oxygen was the most common addressed need; 8% requiring new oxygen and 8% benefitting from oxygen-weaning during the RPM time period. Ten percent patients had emergency department (ED) visits and 4% were readmitted within 30 days of discharge. The authors built and deployed an RPM program for postdischarge monitoring of high-risk patients. RPM can be quickly deployed to support COVID-19 patients postdischarge and assist with hospital capacity. RPM can be rapidly and successfully deployed during the COVID 19 pandemic to aid in transitions of care.

Figure 1.

Escalation pathway for deteriorating patients at the virtual health center Abbreviations: PR, pulse rate; RN, registered nurse; RPM, remote patient monitoring; RR, respiratory rate; SpO2, oxygen saturation; VHC, virtual health center.