Acceptability of and symptom findings from an online symptom check-in tool for COVID-19 outpatient follow-up among a predominantly healthcare worker population

Abstract

IntroductionHealth systems worldwide have had to prepare for a surge in volume in both the outpatient and inpatient settings since the emergence of COVID-19. Early international healthcare experiences showed approximately 80% of patients with COVID-19 had mild disease and therfore could be managed as outpatients. However, SARS-CoV-2 can cause a biphasic illness with those affected experiencing a clinical deterioration usually seen after day 4 of illness.ObjectiveWe created an online tool with the primary objective of allowing for virtual disease triage among the increasing number of outpatients diagnosed with COVID-19 at our hospital. Secondary aims included COVID-19 education and the promotion of official COVID-19 information among these outpatients, and analysis of reported symptomatology.MethodsOutpatients with acute COVID-19 disease received text messages from the hospital containing a link to an online symptom check-in tool which they were invited to complete.Results296 unique participants (72%) from 413 contacted by text completed the online check-in tool at least once, generating 831 responses from 1324 texts sent. 83% of text recipients and 91% of unique participants were healthcare workers. 7% of responses to the tool were from participants who admitted to a slight worsening of their symptoms during follow-up. Fatigue was the most commonly reported symptom overall (79%), followed by headache (72%). Fatigue, headache and myalgia were the most frequently reported symptoms in the first 3 days of illness. 8% of responses generated in the first 7 days of illness did not report any of the cardinal symptoms (fever, cough, dyspnoea, taste/smell disturbance) of COVID-19. Participants found the tool to be useful and easy to use, describing it as ‘helpful’ and ‘reassuring’ in a follow-up feedback survey (n=140). 93% said they would use such a tool in the future. 39% reported ongoing fatigue, 16% reported ongoing smell disturbance and 14% reported ongoing dyspnoea after 6 months.ConclusionThe online symptom check-in tool was found to be acceptable to participants and saw high levels of engagement and satisfaction. Symptomatology findings highlight the variety and persistence of symptoms experienced by those with confirmed COVID-19 disease

COVID-box Experiences of Patients and Health Care Professionals (COVID-box Project): Single-Center, Retrospective, Observational Study

“…During the extraordinary situation of the COVID-19 pandemic, remote telemonitoring has been quickly implemented in different ways [5][6][7][10][11][12][13]. In general, many patients and health care professionals are very positive about this concept.…”

“…Remote telemonitoring is used for conducting disease triage; reducing hospital admissions; and providing reassurance, disease and disease course information, and psychological support to clinically stable patients at home. Several studies have reported that patients appreciate all forms of remote telemonitoring (eg, the measuring of vital parameters, symptom recording, and daily teleconsultations) in various settings (eg, in primary care and after an emergency department visit or hospital admission) [5][6][7][10][11][12][13]. The important aspects are easy access to the program, good information provision, and the good quality of the service for the onboarding process.…”

“…Self-evidently, the adherence of patients to telemonitoring is critical to its success. Nonadherence to telemonitoring among patients with COVID-19 has been reported when they feel too sick, forget to measure vital parameters, feel insufficiently informed, or experience quick improvements in disease symptoms [13]. Health care professionals are largely convinced of the benefits of remote telemonitoring, as long as a program is easy to use and it is possible to receive patient data correctly.…”

“…The implementation of several home monitoring programs has resulted in a reduction in hospital admissions by allowing for the safe survey of clinical symptoms and vitals [3][4][5][6][7][8][9]. Although many observational studies have studied the effectiveness of home monitoring, few studies have reported on patients' and doctors' experiences with telemonitoring [5,[10][11][12][13]. We focused on the COVID-box experiences of patients and health care professionals.…”

Patient Experience and Feedback After Using an Electronic Health Record–Integrated COVID-19 Symptom Checker: Survey Study

“…A handful of studies have reported moderately high user satisfaction ratings for COVID-19 symptom checkers. One study of 296 patients who were predominantly health care workers reported 56% found their institution’s internal web-based symptom checker tool useful [ 11 ]. Symptom checkers for conditions other than COVID-19 have also reported positive user experiences, including 1 study reporting high satisfaction in 70%-80% of users [ 9 ].…”