Background Italy was the first country to largely experience the COVID-19 epidemic among other Western countries during the so-called first wave of the COVID-19 pandemic. Proper management of an increasing number of home-quarantined individuals created a significant challenge for health care authorities and professionals. This was especially true when considering the importance of remote surveillance to detect signs of disease progression and consequently regulate access to hospitals and intensive care units on a priority basis. Objective In this paper, we report on an initiative promoted to cope with the first wave of the COVID-19 epidemic in the Spring/Summer of 2020, in the Autonomous Province of Trento, Italy. A purposefully built app named TreCovid19 was designed to provide dedicated health care staff with a ready-to-use tool for remotely monitoring patients with progressive symptoms of COVID-19, who were home-quarantined during the first wave of the epidemic, and to focus on those patients who, based on their self-reported clinical data, required a quick response from health care professionals. Methods TreCovid19 was rapidly developed to facilitate the monitoring of a selected number of home-quarantined patients with COVID-19 during the very first epidemic wave. The app was built on top of an existing eHealth platform, already in use by the local health authority to provide home care, with the following functionalities: (1) to securely collect and link demographic and clinical information related to the patients and (2) to provide a two-way communication between a multidisciplinary health care team and home-quarantined patients. The system supported patients to self-assess their condition and update the multidisciplinary team on their health status. The system was used between March and June 2020 in the province of Trento. Results A dedicated multidisciplinary group of health care professionals adopted the platform over a period of approximately 3 months (from March-end to June 2020) to monitor a total of 170 patients with confirmed COVID-19 during home quarantine. All patients used the system until the end of the initiative. The TreCovid19 system has provided useful insights of possible viability and impact of a technological–organizational asset to manage a potentially critical workload for the health care staff involved in the periodic monitoring of a relevant number of quarantined patients, notwithstanding its limitations given the rapid implementation of the whole initiative. Conclusions The technological and organizational model adopted in response to the COVID-19 pandemic was developed and finalized in a relatively short period during the initial few weeks of the epidemic. The system successfully supported the health care staff involved in the periodic monitoring of an increasing number of home-quarantined patients and provided valuable data in terms of disease surveillance.
BACKGROUND The large majority of patients infected by the latest coronavirus disease (COVID-19) reports mild symptoms and are usually recovering at their home (quarantine). A proper monitoring of such patients through a system user-friendly for patients and sustainable for healthcare staff is a key aspect to prevent potential worsening of symptoms and to ensure proper medical interventions. OBJECTIVE The aim of this work was to pilot a telemedicine technical and organizational model specifically designed to provide dedicated healthcare staff with a sustainable and reliable tool for periodically monitoring patients with progressive COVID-19 who are home-quarantined. METHODS An easy-to-use App was purposely developed to facilitate the monitoring of a selected number of home-quarantined patients affected by COVID-19. The App was accurately linked with a pre-existing e-health platform adopted by the local health trust to provide home care, allowing: (i) proper and safe link of collected data with demographic and clinical information related to the patients; (ii) a two-way communication between a multidisciplinary healthcare team and home-quarantined patients. The system supported patients to self-assess their conditions and to update the multidisciplinary team on the health status. The system was piloted between March and June 2020, in the Autonomous Province of Trento (Italy). RESULTS A dedicated multidisciplinary group of healthcare professionals adopted the platform over a period of approximately 3 months (from end of March to June 2020) to monitor a total of 170 patients with confirmed COVID-19 while in home-quarantine. All the patients used the system until the end of the study. CONCLUSIONS The technological and organizational model adopted in the context of this piloting has proved to be acceptable for both patients and health care staff when monitoring the progression of COVID-19 during the quarantine period. The system was purposely developed to pilot an innovative system supporting healthcare staff involved in the periodic monitoring of a relevant number of quarantined patients. CLINICALTRIAL NA
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