Remote Patient Monitoring Program for Hospital Discharged COVID-19 Patients

Abstract 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...

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Veröffentlicht in:Applied clinical informatics 2020-10, Vol.11 (5), p.792-801
Hauptverfasser: Gordon, William J., Henderson, Daniel, DeSharone, Avital, Fisher, Herrick N., Judge, Jessica, Levine, David M., MacLean, Laura, Sousa, Diane, Su, Mack Y., Boxer, Robert
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container_end_page 801
container_issue 5
container_start_page 792
container_title Applied clinical informatics
container_volume 11
creator Gordon, William J.
Henderson, Daniel
DeSharone, Avital
Fisher, Herrick N.
Judge, Jessica
Levine, David M.
MacLean, Laura
Sousa, Diane
Su, Mack Y.
Boxer, Robert
description Abstract 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.
doi_str_mv 10.1055/s-0040-1721039
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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.</description><identifier>ISSN: 1869-0327</identifier><identifier>EISSN: 1869-0327</identifier><identifier>DOI: 10.1055/s-0040-1721039</identifier><identifier>PMID: 33241547</identifier><language>eng</language><publisher>Rüdigerstraße 14, 70469 Stuttgart, Germany: Georg Thieme Verlag KG</publisher><subject>Adult ; Aftercare - methods ; Aged ; COVID-19 - epidemiology ; COVID-19 - therapy ; Emergency Service, Hospital - statistics &amp; numerical data ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Patient Discharge ; Patient Readmission - statistics &amp; numerical data ; Research Article</subject><ispartof>Applied clinical informatics, 2020-10, Vol.11 (5), p.792-801</ispartof><rights>Thieme. All rights reserved.</rights><rights>Thieme. All rights reserved. 2020 Georg Thieme Verlag KG</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-e0b61fa58522caad25fa7c23b642caf9122fce307dc0e67bdc742697e932e0ee3</citedby><cites>FETCH-LOGICAL-c428t-e0b61fa58522caad25fa7c23b642caf9122fce307dc0e67bdc742697e932e0ee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688410/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688410/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33241547$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gordon, William J.</creatorcontrib><creatorcontrib>Henderson, Daniel</creatorcontrib><creatorcontrib>DeSharone, Avital</creatorcontrib><creatorcontrib>Fisher, Herrick N.</creatorcontrib><creatorcontrib>Judge, Jessica</creatorcontrib><creatorcontrib>Levine, David M.</creatorcontrib><creatorcontrib>MacLean, Laura</creatorcontrib><creatorcontrib>Sousa, Diane</creatorcontrib><creatorcontrib>Su, Mack Y.</creatorcontrib><creatorcontrib>Boxer, Robert</creatorcontrib><title>Remote Patient Monitoring Program for Hospital Discharged COVID-19 Patients</title><title>Applied clinical informatics</title><addtitle>Appl Clin Inform</addtitle><description>Abstract 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.</description><subject>Adult</subject><subject>Aftercare - methods</subject><subject>Aged</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - therapy</subject><subject>Emergency Service, Hospital - statistics &amp; numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pandemics</subject><subject>Patient Discharge</subject><subject>Patient Readmission - statistics &amp; numerical data</subject><subject>Research Article</subject><issn>1869-0327</issn><issn>1869-0327</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><sourceid>EIF</sourceid><recordid>eNp1kc9PwyAUx4nRODN39Wh69NIJlEJ7MTHzZ5zRGPVKKH3tWNoyoTXxvxezzcyDXOCFz_s--H4ROiF4SnCanvsYY4ZjIijBSb6HjkjG8xgnVOzvnEdo4v0Sh5VykmXiEI2ShDKSMnGEHl6gtT1Ez6o30PXRo-1Mb53p6ujZ2dqpNqqsi-6sX5leNdGV8XqhXA1lNHt6v7-KSb7t9cfooFKNh8lmH6O3m-vX2V08f7q9n13OY81o1seAC04qlWYppVqpkqaVEpomBWehrnJCaaUhwaLUGLgoSi0Y5bmAPKGAAZIxuljrroaihVKH2U41cuVMq9yXtMrIvzedWcjafkrBs4wFq8bobCPg7McAvpdt-BY0jerADl5SxhnHnGAe0Oka1c5676D6HUOw_AlBevkTgtyEEBpOdx_3i28tD0C8BvqFgRbk0g6uC3b9J_gNp9-QYg</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Gordon, William J.</creator><creator>Henderson, Daniel</creator><creator>DeSharone, Avital</creator><creator>Fisher, Herrick N.</creator><creator>Judge, Jessica</creator><creator>Levine, David M.</creator><creator>MacLean, Laura</creator><creator>Sousa, Diane</creator><creator>Su, Mack Y.</creator><creator>Boxer, Robert</creator><general>Georg Thieme Verlag KG</general><scope>0U6</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202010</creationdate><title>Remote Patient Monitoring Program for Hospital Discharged COVID-19 Patients</title><author>Gordon, William J. ; Henderson, Daniel ; DeSharone, Avital ; Fisher, Herrick N. ; Judge, Jessica ; Levine, David M. ; MacLean, Laura ; Sousa, Diane ; Su, Mack Y. ; Boxer, Robert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-e0b61fa58522caad25fa7c23b642caf9122fce307dc0e67bdc742697e932e0ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aftercare - methods</topic><topic>Aged</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - therapy</topic><topic>Emergency Service, Hospital - statistics &amp; numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pandemics</topic><topic>Patient Discharge</topic><topic>Patient Readmission - statistics &amp; numerical data</topic><topic>Research Article</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gordon, William J.</creatorcontrib><creatorcontrib>Henderson, Daniel</creatorcontrib><creatorcontrib>DeSharone, Avital</creatorcontrib><creatorcontrib>Fisher, Herrick N.</creatorcontrib><creatorcontrib>Judge, Jessica</creatorcontrib><creatorcontrib>Levine, David M.</creatorcontrib><creatorcontrib>MacLean, Laura</creatorcontrib><creatorcontrib>Sousa, Diane</creatorcontrib><creatorcontrib>Su, Mack Y.</creatorcontrib><creatorcontrib>Boxer, Robert</creatorcontrib><collection>Thieme Connect Journals Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Applied clinical informatics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gordon, William J.</au><au>Henderson, Daniel</au><au>DeSharone, Avital</au><au>Fisher, Herrick N.</au><au>Judge, Jessica</au><au>Levine, David M.</au><au>MacLean, Laura</au><au>Sousa, Diane</au><au>Su, Mack Y.</au><au>Boxer, Robert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Remote Patient Monitoring Program for Hospital Discharged COVID-19 Patients</atitle><jtitle>Applied clinical informatics</jtitle><addtitle>Appl Clin Inform</addtitle><date>2020-10</date><risdate>2020</risdate><volume>11</volume><issue>5</issue><spage>792</spage><epage>801</epage><pages>792-801</pages><issn>1869-0327</issn><eissn>1869-0327</eissn><abstract>Abstract 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.</abstract><cop>Rüdigerstraße 14, 70469 Stuttgart, Germany</cop><pub>Georg Thieme Verlag KG</pub><pmid>33241547</pmid><doi>10.1055/s-0040-1721039</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aftercare - methods
Aged
COVID-19 - epidemiology
COVID-19 - therapy
Emergency Service, Hospital - statistics & numerical data
Female
Humans
Male
Middle Aged
Pandemics
Patient Discharge
Patient Readmission - statistics & numerical data
Research Article
title Remote Patient Monitoring Program for Hospital Discharged COVID-19 Patients
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