National Institute of Epidemiology, Indian Council of Medical Research, Chennai, India.
Greater Chennai Corporation, Government of Tamil Nadu, Chennai, India.
Glob Health Sci Pract. 2023 Feb 28;11(1). doi: 10.9745/GHSP-D-21-00458.
During the early months of the COVID-19 pandemic in 2020, the majority of the identified COVID-19 patients in Chennai, a southern metropolitan city of India, presented as asymptomatic or with mild clinical illness. Providing facility-based care for these patients was not feasible in an overburdened health system. Thus, providing home-based clinical care for patients who were asymptomatic or with mild clinical illnesses was a viable solution. Because of the imminent possibility of worsening clinical conditions in home-isolated COVID-19 patients, continuous monitoring for red flag signs was essential. With growing evidence of the effectiveness of remote monitoring of patients, the Greater Chennai Corporation in partnership with the National Institute of Epidemiology conceptualized and implemented a remote monitoring program for home-isolated COVID-19 patients. The key steps used to develop the program were to (1) decentralize triage systems and establish a home-isolation protocol, (2) develop a remote monitoring platform and remote health care workforce, and (3) onboard patients and conduct remote hybrid monitoring. In this article, we share the pragmatic solutions, critical components of the systems and processes, lessons, and experiences in implementing a remote monitoring program for home-isolated COVID-19 patients in a large metropolitan setting.
在 2020 年 COVID-19 大流行的早期，印度南部大都市钦奈的大多数 COVID-19 患者表现为无症状或轻度临床疾病。在负担过重的卫生系统中，为这些患者提供基于设施的护理是不可行的。因此，为无症状或轻度临床疾病的患者提供基于家庭的临床护理是一个可行的解决方案。由于居家隔离的 COVID-19 患者病情恶化的可能性迫在眉睫，因此对危险信号进行持续监测至关重要。随着远程监测患者有效性的证据不断增加，大钦奈市与国家流行病学研究所合作，为居家隔离的 COVID-19 患者构思和实施了远程监测计划。开发该计划所采用的关键步骤包括：(1) 分散分诊系统并建立居家隔离协议；(2) 开发远程监测平台和远程医疗劳动力；以及 (3) 为患者提供服务并进行远程混合监测。在本文中，我们分享了在大型大都市环境中为居家隔离的 COVID-19 患者实施远程监测计划的务实解决方案、系统和流程的关键组成部分、经验教训和体会。
