Efficacy of Telemedicine and Telemonitoring in At-Home Monitoring of Patients with COVID-19.

Emilio Casariego-Vales,Ramón Ares-Rico,Roi Suárez-Gil,María Dobao-Feijoo,Benigno Rosón-Calvo,Rosa Blanco-López,Fernando Santos-Guerra,Mercedes Bal-Alvaredo

doi:10.3390/jcm10132893

Emilio Casariego-Vales, Ramón Ares-Rico + Show 6 more

Open Access

https://doi.org/10.3390/jcm10132893

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Abstract

Aim: this work aims to assess if telemedicine and telemonitoring are clinically useful and safe for at-home monitoring of Coronavirus disease 2019 (COVID-19) patients. Methods: This is a retrospective cohort study of all patients diagnosed with COVID-19 in Galicia (Northwestern Spain) between 26 December 2020 and 15 February 2021. The structured, proactive monitoring via telemonitoring (TELEA) of patients considered to be high-risk in the Lugo, A Mariña, and Monforte Healthcare Area (ASLAM) was evaluated compared to other models in the remaining healthcare areas of Galicia. Results: Of the 47,053 COVID-19 patients, 4384 (9.3%) were in ASLAM. Of them, 1187 (27.1%) were monitored via TELEA, and the rest (3197 in ASLAM and 42,669 in the rest of Galicia) were monitored via other methods. Patients monitored in ASLAM via TELEA were older, consulted in the emergency department less frequently (p = 0.05), were hospitalized less frequently (p < 0.01), had shorter hospital stays (p < 0.0001), and had a lower mortality rate in their first hospitalization (p = 0.03). No at-home life-threatening emergencies were recorded. Conclusions: these data suggest that, for COVID-19 patients, a care model involving proactive at-home monitoring with telemedicine and telemonitoring is associated with reduced pressure on hospital services and a lower mortality rate.

Highlights

Coronavirus disease 2019 (COVID-19), the disease caused by the SARS-CoV-2 virus, is characterized by its sudden and widespread dissemination, accelerated clinical progression, and tragic consequences [1,2,3]
This work is a retrospective cohort study of all individuals diagnosed with COVID-19 via polymerase chain reaction (PCR) and/or antigen detection in nasopharyngeal exudate in the Autonomous Community of Galicia (Northwestern Spain) in the third wave of the COVID-19 pandemic
Between the start of the pandemic in March 2020 and 15 February 2021, a total of 105,257 individuals were diagnosed with COVID-19 in Galicia

Summary

Introduction

Coronavirus disease 2019 (COVID-19), the disease caused by the SARS-CoV-2 virus, is characterized by its sudden and widespread dissemination, accelerated clinical progression, and tragic consequences [1,2,3]. Since 2015, the Galician Health System (Servicio Galego de Saúde (SERGAS)), in Northwestern Spain, has had a telemedicine tool available as part of the electronic medical record. This tool, called Telemedicina y Telemonitorización Asistencial (TELEA) allows for the at-home monitoring of patients from a “virtual ward” [11]. Since its creation, it has been used for monitoring patients with chronic diseases. Following an adaptation of the tools and procedures in 2020, it is used in patients with COVID-19 [8]

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