Home Monitoring Program Assisted COVID-19 Patients

June 22, 2023 - A study published in the American Journal of Accountable Care indicated that COVID-19 patients at risk of decompensation benefited highly from a home monitoring program, allowing most to limit emergency department (ED) visitation.

The COVID-19 pandemic led to higher levels of leniency surrounding telehealth use. While aiming to lessen the burden on local hospital systems, Denver Health leveraged these allowances to create a home monitoring program for patients with COVID-19. Previous studies indicate that research surrounding telehealth use during the COVID-19 pandemic is plentiful. However, data surrounding perspectives of patient monitoring programs are sparser.

Based in Colorado, Denver Health is an integrated safety-net healthcare system. It operates through 9 federally qualified community health and urgent care clinics, providing primary and acute care. The patient population is relatively diverse, over half of whom are from racial and ethnic minority groups.

Denver Health created the home monitoring program to build efficiency within the health system. It extended supportive care and home monitoring tools to those with COVID-19 who were at risk for clinical deterioration. Resources included blood pressure cuffs, thermometers, and pulse oximeters, generally defined as durable medical equipment (DME). Patients also communicated with nurses and physicians twice a day via phone.

Operating between April 2020 and November 2020, the program monitored 668 patients, 155 of whom participated in the study. All patients had a suspected COVID-19 diagnosis, and 63 percent eventually tested positive.

Researchers composed a survey to gather insight into patient experiences with the program. This was a cross-sectional telephone survey that consisted of 20 questions that covered 5 domains. These domains included perception of this type of care, perception of DME, frequency of calls through the program, access, and engagement.

Among 80 survey respondents, 91 percent rated the program a 9 or 10 on a 1–10 scale. When asked about endorsement, 90 percent would recommend this type of program to peers. Also, 90 percent stated they would participate in a program such as this one for issues unrelated to COVID-19.

The program also led 79 percent of survey respondents to feel less of a need to visit the ED. Meanwhile, 88.9 percent reported feeling more in control of their medical condition, and 93.8 percent felt as though they gained a better understanding of their condition.

DME use, however, was short of what was expected. Although training in DME was relatively frequent, only about 70 percent of patients indicated having used these tools. However, 91.6 percent of users indicated comfort when using DME.

Regarding the number of phone calls involved in the program, 87.7 percent felt as though it was appropriate. Perceptions of monitoring duration were also positive, as 95.1 percent supplied positive results.

Many patients did, however, have trouble accessing the electronic health record (EHR) patient portal. Even though 85 percent of participants had a smartphone and 74 percent had internet access, 53 percent could view the EHR patient portal.

Among a relatively high level of positive results, researchers noted that this home monitoring program was effective in treating patients with COVID-19. They also mentioned that advancing technology will prompt the need to also accelerate patient training on behalf of these resources.

Throughout the COVID-19 pandemic, the use of home monitoring tools to treat this condition was common.

A study from March 2022 described the success of a remote patient monitoring program in treating patients with COVID-19.

This research process consisted of a review of 1,128 COVID-19 patients that participated in the home monitoring program. Under the consideration of various demographics, researchers identified patients who were high- and low-risk.

The main variable they considered was the share of patients who faced hospitalization after engaging in the program. Although only 6.2 percent were hospitalized and 1.2 percent were admitted to the intensive care unit, hospitalization was more common among those who were high-risk. However, given that 92 percent of patients did not face hospitalization, researchers defined a level of efficacy associated with the program.