University of Washington School of Medicine, Seattle, WA, USA.
Division of GIM/Hospital Medicine, Harborview Medical Center, Seattle, WA, USA.
J Gen Intern Med. 2024 Jun;39(8):1288-1293. doi: 10.1007/s11606-023-08581-x. Epub 2023 Dec 27.
During the coronavirus disease 2019 (COVID-19) pandemic, hospitals and healthcare systems launched innovative responses to emerging needs. The creation and use of programs to remotely follow patient clinical status and recovery after COVID-19 hospitalization has not been thoroughly described.
To characterize deployment of remote post-hospital discharge monitoring programs during the COVID-19 pandemic METHODS: Electronic surveys were administered to leaders of 83 US academic hospitals in the Hospital Medicine Re-engineering Network (HOMERuN). An initial survey was completed in March 2021 with follow-up survey completed in July 2022.
There were 35 responses to the initial survey (42%) and 15 responses to the follow-up survey (43%). Twenty-two (63%) sites reported a post-discharge monitoring program, 16 of which were newly developed for COVID-19. Physiologic monitoring devices such as pulse oximeters were often provided. Communication with medical teams was often via telephone, with moderate use of apps or electronic medical record integration. Programs launched most commonly between January and June 2020. Only three programs were still active at the time of follow-up survey.
Our findings demonstrate rapid, ad hoc development of post-hospital discharge monitoring programs during the COVID-19 pandemic but with little standardization or evaluation. Additional study could identify the benefits of these programs, instruct their potential application to other disease processes, and inform further development as part of emergency preparedness for upcoming crises.
在 2019 年冠状病毒病(COVID-19)大流行期间,医院和医疗保健系统针对新出现的需求推出了创新应对措施。创建和使用程序来远程跟踪 COVID-19 住院后患者的临床状况和康复情况尚未得到充分描述。
描述在 COVID-19 大流行期间远程出院后监测计划的部署情况。
对医院医学再设计网络(HOMERuN)中 83 家美国学术医院的领导进行了电子调查。2021 年 3 月完成了初始调查,2022 年 7 月完成了后续调查。
初始调查有 35 份回复(42%),后续调查有 15 份回复(43%)。22 个(63%)站点报告了出院后监测计划,其中 16 个是为 COVID-19 新开发的。通常提供生理监测设备,如脉搏血氧仪。与医疗团队的沟通通常通过电话进行,适度使用应用程序或电子病历集成。这些计划最常于 2020 年 1 月至 6 月推出。在后续调查时,只有三个计划仍在运行。
我们的发现表明,在 COVID-19 大流行期间迅速、临时开发了出院后监测计划,但缺乏标准化或评估。进一步的研究可以确定这些计划的益处,指导它们在其他疾病过程中的潜在应用,并为即将到来的危机的应急准备提供进一步的发展信息。