Kuo Sherwin, Aledia Anna, O'Connell Ryan, Rudkin Scott, Dangodara Amish A, Amin Alpesh N
Department of Medicine/Hospital Medicine, UC Irvine Health, Orange, California, USA.
Clinical Informatics Program, UC Irvine Health, Orange, California, USA.
JAMIA Open. 2022 Jul 1;5(3):ooac060. doi: 10.1093/jamiaopen/ooac060. eCollection 2022 Oct.
In order to manage COVID-19 patient population and bed capacity issues, remote patient monitoring (RPM) is a strategy used to transition patients from inpatients to home. We describe our RPM implementation process for post-acute care COVID-19 pneumonia patients. We also evaluate the impact of RPM on patient outcomes, including hospital length of stay (LOS), post-discharge Emergency Department (ED) visits, and hospital readmission.
We utilized a cloud-based RPM platform (Vivify Health) and a nurse-monitoring service (Global Medical Response) to enroll COVID-19 patients who required oxygen supplementation after hospital discharge. We evaluated patient participation, biometric alerts, and provider communication. We also assessed the program's impact by comparing RPM patient outcomes with a retrospective cohort of Control patients who similarly required oxygen supplementation after discharge but were not referred to the RPM program. Statistical analyses were performed to evaluate the 2 groups' demographic characteristics, hospital LOS, and readmission rates.
The RPM program enrolled 75 patients with respondents of a post-participation survey reporting high satisfaction with the program. Compared to the Control group ( = 150), which had similar demographics and baseline characteristics, the RPM group was associated with shorter hospital LOS (median 4.8 vs 6.1 days; =.03) without adversely impacting return to the ED or readmission.
We implemented a RPM program for post-acute discharged COVID-19 patients requiring oxygen supplementation. Our RPM program resulted in a shorter hospital LOS without adversely impacting quality outcomes for readmission rates and improved healthcare utilization by reducing the average LOS.
为了应对新冠病毒疾病(COVID-19)患者数量和床位容量问题,远程患者监测(RPM)是一种用于将患者从住院转为居家治疗的策略。我们描述了针对急性后护理COVID-19肺炎患者的RPM实施过程。我们还评估了RPM对患者结局的影响,包括住院时间(LOS)、出院后急诊室(ED)就诊情况以及再次入院情况。
我们利用基于云的RPM平台(Vivify Health)和护士监测服务(Global Medical Response),纳入出院后仍需吸氧的COVID-19患者。我们评估了患者参与情况、生物特征警报以及与医护人员的沟通。我们还通过将RPM患者的结局与一组回顾性对照患者进行比较,评估了该项目的影响。这些对照患者同样在出院后需要吸氧,但未被纳入RPM项目。进行了统计分析,以评估两组的人口统计学特征、住院时间和再入院率。
RPM项目纳入了75名患者,参与后调查的受访者对该项目满意度很高。与具有相似人口统计学和基线特征的对照组(n = 150)相比,RPM组的住院时间更短(中位数4.8天对6.1天;P =.03),且对再次前往急诊室或再次入院没有不利影响。
我们为出院后仍需吸氧的急性后COVID-19患者实施了RPM项目。我们的RPM项目缩短了住院时间,且对再入院率这一质量结局没有不利影响,并通过缩短平均住院时间提高了医疗资源利用率。