A Virtual Ward Model of Care for Patients With COVID-19: Retrospective Single-Center Clinical Study.

Olivia R Ferry,Cameron J Bennett,Emma C Moloney,Owen T Spratt,Gerald F M Whiting

doi:10.2196/25518

Abstract

BackgroundCOVID-19 has necessitated the implementation of innovative health care models in preparation for an influx of patients. A virtual ward model delivers clinical care remotely to patients in isolation. We report on an Australian cohort of patients with COVID-19 treated in a virtual ward.ObjectiveThe aim of this study was to describe and evaluate the safety and efficacy of a virtual ward model of care for an Australian cohort of patients with COVID-19.MethodsRetrospective clinical assessment was performed for 223 patients with confirmed COVID-19 treated in a virtual ward in Brisbane, Australia, from March 25 to May 15, 2020. Statistical analysis was performed for variables associated with the length of stay and hospitalization.ResultsOf 223 patients, 205 (92%) recovered without the need for escalation to hospital care. The median length of stay in the virtual ward was 8 days (range 1-44 days). In total, 18 (8%) patients were referred to hospital, of which 6 (33.3%) were discharged after assessment at the emergency department. Furthermore, 12 (5.4%) patients were admitted to hospital, of which 4 (33.3%) required supplemental oxygen and 2 (16.7%) required mechanical ventilation. No deaths were recorded. Factors associated with escalation to hospital care were the following: hypertension (odds ratio [OR] 3.6, 95% CI 1.28-9.87; P=.01), sputum production (OR 5.2, 95% CI 1.74-15.49; P=.001), and arthralgia (OR 3.8, 95% CI 1.21-11.71; P=.02) at illness onset and a polymerase chain reaction cycle threshold of ≤20 on a diagnostic nasopharyngeal swab (OR 5.0, 95% CI 1.25-19.63; P=.02).ConclusionsOur results suggest that a virtual ward model of care to treat patients with COVID-19 is safe and efficacious, and only a small number of patients would potentially require escalation to hospital care. Further studies are required to validate this model of care.

Highlights

On March 11, 2020, the World Health Organization declared COVID-19, a respiratory infection due to SARS-CoV-2, as a global pandemic [1]
Factors associated with escalation to hospital care were the following: hypertension, sputum production, and arthralgia at illness onset and a polymerase chain reaction cycle threshold of ≤20 on a diagnostic nasopharyngeal swab
Our results suggest that a virtual ward model of care to treat patients with COVID-19 is safe and efficacious, and only a small number of patients would potentially require escalation to hospital care

Summary

Introduction

On March 11, 2020, the World Health Organization declared COVID-19, a respiratory infection due to SARS-CoV-2, as a global pandemic [1]. A key consideration in this pandemic has been the management of the rapid influx of patients with COVID-19. The subsequent strain on health care systems has acted as a catalyst for increasing the implementation of telemedicine [2]. Telemedicine refers to health care provision through information technologies and telecommunication systems [3]. The implementation of novel telemedicine approaches can be challenging, since adaptation of both staff and patients is required. During COVID-19, telemedicine has been used to triage, treat, and coordinate care provision to patients with http://www.jmir.org/2021/2/e25518/. COVID-19 has necessitated the implementation of innovative health care models in preparation for an influx of patients. A virtual ward model delivers clinical care remotely to patients in isolation. We report on an Australian cohort of patients with COVID-19 treated in a virtual ward

Methods

Results

Discussion

Conclusion