Abstract
Established technology, operational infrastructure, and nursing resources were leveraged to develop a remote patient monitoring (RPM) program for ambulatory management of patients with COVID-19. The program included two care-delivery models with different monitoring capabilities supporting variable levels of patient risk for severe illness. The primary objective of this study was to determine the feasibility and safety of a multisite RPM program for management of acute COVID-19 illness. We report an evaluation of 7074 patients served by the program across 41 US states. Among all patients, the RPM technology engagement rate was 78.9%. Rates of emergency department visit and hospitalization within 30 days of enrollment were 11.4% and 9.4%, respectively, and the 30-day mortality rate was 0.4%. A multisite RPM program for management of acute COVID-19 illness is feasible, safe, and associated with a low mortality rate. Further research and expansion of RPM programs for ambulatory management of other acute illnesses are warranted.
Highlights
At the onset of the COVID-19 pandemic and executive shelter-inplace orders in March 2020, there was an urgent need to develop new ways to support ambulatory patients with SARS-CoV-2 infection at risk for severe COVID-19 illness, decompress hospitals and emergency departments (ED), and preserve personal protective equipment (PPE)[1]
This study aims to address the noted gaps in the medical literature by evaluating how an remote patient monitoring (RPM) program can be effectively adapted at scale to facilitate multisite and multi-regional, ambulatory management of a large population of patients with an acute condition
Over the eight months following the COVID-19 pandemic emergency declaration, 8548 patients enrolled in the RPM program and 7074 were evaluable for this feasibility and safety analysis
Summary
At the onset of the COVID-19 pandemic and executive shelter-inplace orders in March 2020, there was an urgent need to develop new ways to support ambulatory patients with SARS-CoV-2 infection at risk for severe COVID-19 illness, decompress hospitals and emergency departments (ED), and preserve personal protective equipment (PPE)[1]. Global health care systems were forced to either create new telehealth and virtual caredelivery models or drive the adoption of existing and repurposed products and services[2]. Mayo Clinic leveraged and rapidly scaled mature telehealth and virtual care services in response to the pandemic in support of patients with serious and complex conditions[6,7]. New services with existing products were developed to support the clinical management of patients with acute COVID-197. One such example was the utilization of the existing remote patient monitoring (RPM) technology with its operational infrastructure and clinical resources
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