Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States.
Appl Clin Inform. 2020 Oct;11(5):792-801. doi: 10.1055/s-0040-1721039. Epub 2020 Nov 25.
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.
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 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.
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; = 0.039). Referral without enrollment was not associated with a reduced odds of ED or hospital readmission.
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.
我们部署了远程患者监测(RPM)计划,以监测出院后患有 2019 年冠状病毒病(COVID-19)的患者。我们描述了 RPM 计划中患者的特征、计划特征和临床结局。
我们招募了从医院出院回家的 COVID-19 患者。入组患者使用一个应用程序,并配备了脉搏血氧仪和温度计。患者每天自行报告症状、血氧饱和度和体温。异常症状或生命体征会被标记出来,并由一组护士进行评估。使用描述性统计数据来描述患者和计划特征。使用混合效应逻辑回归模型来确定急诊部(ED)或医院再入院的联合终点的可能性。
共有 295 名患者从五家参与医院被转介到 RPM,其中 225 名患者被入组。大多数入组患者(66%)在未触发异常警报的情况下完成了监测期。入组与 ED 或医院再入院的可能性降低相关(调整后的优势比:0.54;95%置信区间:0.3-0.97;P=0.039)。未入组的转介与 ED 或医院再入院的可能性降低无关。
COVID-19 的 RPM 提供了一种机制,可以在患者的家庭环境中监测患者并减少医院的使用。我们的工作表明,RPM 降低了 COVID-19 患者的再入院率,并提供了在出院后可扩展的远程监测能力。COVID-19 患者出院后的 RPM 与 ED 或医院再入院的风险降低相关,并为在家中环境中监测患者提供了一种可扩展的机制。