Remote Patient Monitoring for Global Emergencies: Case Study in Patients With COVID-19

Abstract

Background: The COVID-19 pandemic has highlighted the critical need for telehealth and remote patient monitoring in health care delivery. Despite the growing use of on-body wearable sensors for continuous monitoring and predicting adverse events, their widespread adoption remains a significant challenge. While the pandemic has accelerated the acceptance of these technologies, achieving widespread integration requires their sustained incorporation into routine health care practices beyond emergencies. In this study, we extend the application of our previously developed remote patient monitoring system to patients with COVID-19.

Objective: Our objective is to assess whether the metrics obtained from our previously developed system can provide additional insights into the recovery trajectory of individuals affected by COVID-19. This case study aims to demonstrate that remote patient monitoring systems can be adapted to diverse patient cohorts during emergencies. We aim to illustrate the ease of deployment, particularly when these systems are already integrated into the existing health care ecosystem.

Methods: From November 2020 to July 2021, a total of 73 patients were recruited through the University of California, Los Angeles, Center for Smart Health, after having consented to participate in this study for 2 weeks. The research concentrated on an exploratory analysis, focusing on the detailed examination of characteristics and behaviors of patients with COVID-19 as captured by the remote patient monitoring system. We collected day-to-day changes in the following sensor measurements: daily activity, daily energy expenditure, indoor localization, SpO2, respiratory rate, heart rate, and temperature.

Results: Out of the 73 patients satisfying the inclusion criteria, 41 successfully adhered to using the monitoring technology, with only 22 providing substantial watch data (>4 h). Among the participants, 39 used the pulse oximeter, 37 used the thermometer, and 36 used respiratory monitoring at night. This study demonstrated an overall increase in patients' activity levels toward the end of this study, with many beginning to leave their homes after 2 weeks. Additionally, respiratory rates shifted toward healthier lower levels, and oxygen saturation improved. Fatigue and headache were identified as the most prevalent symptoms, followed by cough and loss of smell.

Conclusions: The conclusion highlights the critical importance of monitoring patients outside of hospital settings, especially during pandemics, when patients travel to hospitals or receive home visits by health care professionals, which could increase the risk of disease transmission. Studies demonstrating the benefits and efficacy of remote monitoring in home settings can better prepare health care professionals for future pandemic events. Continuous monitoring of a wide range of patient metrics, from activities to vital signs, and integration of these data into electronic health records would not only improve accuracy and reduce the burden of data collection but also pave the way for enhanced home care, offering higher quality care at a lower cost.

Keywords: Bluetooth Low Energy beacons; COVID-19; health care delivery models; indoor localization; mobile phone; physical activity; remote sensing technology; smartwatches; wearable sensors.

Figure 1.. Average energy intensity: first day versus last day.

Figure 2.. Heatmap of patients' activities during the 2-week study.

Figure 3.. Biomarkers: first day versus last day.