Cheng Courtney, Manji Karishma, Appel Lora, Smith Christopher
Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL.
Family and Community Medicine, University of Toronto, Toronto, CAN.
Cureus. 2022 Jun 23;14(6):e26263. doi: 10.7759/cureus.26263. eCollection 2022 Jun.
Due to the coronavirus disease 2019 (COVID-19) pandemic, a remote monitoring pathway was developed at Michael Garron Hospital to allow individuals with confirmed or presumed COVID-19 infection to successfully manage their illness at home. This study aims to understand patients' experiences on this remote monitoring pathway and to investigate the effectiveness of the pathway in preventing unnecessary emergency department (ED) visits and detecting severe infection.
A total of 35 semi-structured interviews were conducted over the phone. Researchers reviewed transcripts to come up with an index of nodes. Two researchers initially coded the same four transcripts to ensure high inter-rater reliability. The remaining 31 transcripts were coded by one researcher.
Of patients, 80% (n = 28) had a positive experience on the pathway. Remote monitoring was effective in reassuring 22.9% of patients (n = 8) with mild-moderate symptoms that their symptoms were not significant enough to go to the ED and they were monitored at home. A total of 8.6% of patients (n = 3) were correctly identified as having severe symptoms while on the pathway and were asked to present to the hospital. For 8.6% of patients (n = 3), remote monitoring did not identify their severe COVID-19 illness. Of patients, 2.9% (n = 1) were incorrectly identified as having severe COVID-19 symptoms when they were clinically well.
Remote monitoring is an effective tool to optimize healthcare resources during a pandemic. It reduces ER visits and provides a means for routine follow-up while minimizing virus exposure. Patients generally had a positive experience; however, more research needs to be done on optimizing the detection of severe infection.
由于2019年冠状病毒病（COVID-19）大流行，迈克尔·加伦医院开发了一种远程监测途径，以使确诊或疑似感染COVID-19的患者能够在家中成功管理自己的病情。本研究旨在了解患者在这种远程监测途径上的体验，并调查该途径在预防不必要的急诊科（ED）就诊和检测严重感染方面的有效性。
通过电话进行了总共35次半结构化访谈。研究人员审查了访谈记录以得出节点索引。两名研究人员最初对相同的四份访谈记录进行编码，以确保较高的评分者间信度。其余31份访谈记录由一名研究人员进行编码。
80%（n = 28）的患者对该途径有积极体验。远程监测有效地让22.9%（n = 8）有轻至中度症状的患者放心，他们的症状不足以前往急诊科，可在家中接受监测。共有8.6%（n = 3）的患者在该途径上被正确识别为有严重症状，并被要求前往医院就诊。对于8.6%（n = 3）的患者，远程监测未识别出他们的严重COVID-19疾病。2.9%（n = 1）的患者在临床状况良好时被错误识别为有严重COVID-19症状。
远程监测是在大流行期间优化医疗资源的有效工具。它减少了急诊就诊次数，并提供了常规随访的手段，同时最大限度地减少了病毒暴露。患者总体上有积极体验；然而，在优化严重感染的检测方面还需要更多研究。
