Early Hospital Discharge Using Remote Monitoring for Patients Hospitalized for COVID-19, Regardless of Need for Home Oxygen Therapy: A Descriptive Study

Abstract

Aim: Since beds are unavailable, we prospectively investigated whether early hospital discharge will be safe and useful in patients hospitalized for COVID-19, regardless of their need for home oxygen therapy. Population and Methods: Extending the initial inclusion criteria, 62 patients were included and 51 benefited from home telemonitoring, mainly assessing clinical parameters (blood pressure, heart rate, respiratory rate, dyspnea, temperature) and peripheral saturation (SpO2) at follow-up. Results: 47% of the patients were older than 65 years; 63% needed home oxygen therapy and/or presented with more than one comorbidity. At home, the mean time to dyspnea and tachypnea resolutions ranged from 21 to 24 days. The mean oxygen-weaning duration was 13.3 ± 10.4 days, and the mean SpO2 was 95.7 ± 1.6%. The nurses and/or doctors managed 1238 alerts. Two re-hospitalizations were required, related to transient chest pain or pulmonary embolism, but no death occurred. Patient satisfaction was good, and 743 potential days of hospitalization were saved for other patients. Conclusion: The remote monitoring of vital parameters and symptoms is safe, allowing for early hospital discharge in patients hospitalized for COVID-19, whether or not home oxygen therapy was required. Oxygen tapering outside the hospital allowed for a greater reduction in hospital stay. Randomized controlled trials are necessary to confirm this beneficial effect.

CHIVID: A Rapid Deployment of Community and Home Isolation During COVID-19 Pandemics

“…However, this approach may be impractical in countries without popular chat platforms or facing restrictions. In such cases, rather than create a new application, we recommend utilizing the existing digital care platform [10] , [13] or the web application with short messaging service (SMS) integration from telecom services for patient notifications and remote health monitoring offering a viable alternative in the absence of suitable messaging platforms. This approach ensures scalability and practicality without requiring a significant amount of time for development.…”

“…During crises, several countries implemented telemedicine solutions to provide patient care [8] , [9] . Some systems developed new application systems, while others utilized existing digital care platforms or relied on social messaging apps to communicate with patients during the COVID-19 crisis [10] , [11] , [12] , [13] , [14] , [15] , [16] , as indicated in Supplement Table 1 . However, the monitoring systems share several functions, such as dashboards for monitoring vital signs or alarm systems to alert healthcare practitioners of anomalies.…”

Liability of Health Professionals Using Sensors, Telemedicine and Artificial Intelligence for Remote Healthcare

“…As far as possible, when sensors and/or AI are used, there should be a document precisely defining the responsibility of each participant. For example, remote telemonitoring has been widely used during the COVID-19 pandemic in order to obtain early hospital discharge, allowing beds to be saved for other patients, and it will again be used to follow the numerous patients suffering from long COVID [ 11 , 67 , 68 , 69 ]. This is a simple use case, but doctors would have been responsible if one parameter (blood saturation decrease related to worsening of pneumopathy secondary to virus spreading) were not to be detected or not transmitted early enough to the doctor.…”

“…Liability for damage caused by things involves the liability of a person who causes damage to another person with a thing “of which he had the use, direction and control at the time of the damage” [ 11 ]. Liability for damage caused by things presupposes an act on the part of the thing causing the damage and finds its legal basis in Article 1242 of the French Civil Code.…”

“…Thus, the use of remote monitoring for vital parameters and symptoms allowed for early hospital discharge of patients hospitalized for COVID-19, even those requiring oxygen therapy. The reduction in hospital stay likely resulted in more beds being available for other patients, which is critical during sanitary crises [ 11 ].…”