Oncology Patients' Perspectives on Remote Patient Monitoring for COVID-19

Abstract

PURPOSE: Oncology patients are vulnerable to adverse outcomes associated with COVID-19, and clinical deterioration must be identified early. Several institutions launched remote patient monitoring programs (RPMPs) to care for patients with COVID-19. We describe patients' perspectives on a COVID-19 RPMP at a National Comprehensive Cancer Center. METHODS: Patients who tested positive for COVID-19 were eligible. Enrolled patients received a daily electronic COVID-19 symptom assessment, and a subset of high-risk patients also received a pulse oximeter. Monitoring was provided by a centralized team and was discontinued 14 days after a patient's positive test result and following 3 days without worsening symptoms. Patients who completed at least one assessment and exited the program were sent a patient engagement survey to evaluate the patient's experience with digital monitoring for COVID-19. RESULTS: The survey was distributed to 491 patients, and 257 responded (52% completion rate). The net promoter score was 85%. Most patients agreed that the RPMP was worthwhile, enabled better management of their COVID-19 symptoms, made them feel more connected to their healthcare team, and helped prevent emergency room visits. Identified themes regarding patient-perceived value of a RPMP included (1) security: a clinical safety net; (2) connection: a link to their clinical team during a period of isolation; and (3) empowerment: an education on the virus and symptom management. CONCLUSION: RPMPs are perceived to be of value to oncology patients with COVID-19. Policymakers should consider how these programs can be reimbursed to keep vulnerable patients at home and out of the acute care setting.

Cancer patients’ perspectives on remote monitoring at home during the COVID-19 pandemic- a qualitative study in Norway

“…Even if participants’ views seemed to grow more positive over time, they emphasized both positive and negative effects of the remote monitoring. Studies have shown that cancer patients appreciate that remote monitoring provides information and a clinical safety net, also being a link to the nurses and physicians during a period of isolation [ 17 , 32 , 33 ]. Technological barriers, such as software defects, access to video-compatible devices, access to high-speed internet, and individual technological fluency has been associated with decreased satisfaction [ 34 , 35 ].…”

“…A semi-structured interview guide was developed based on previous research on cancer patients’ experiences with remote monitoring e.g. [ 17 , 18 ], and through several discussions within the research group until consensus was reached (see Table 1 ).…”

“…Several recommendations have been presented to reduce the frequency of cancer patients’ visits to oncology centers while maintaining access to cancer therapy and minimizing the risk of exposure to COVID-19, such as activating telemedicine and applying innovative ideas to minimize patients’ visits in hospital [ 16 ]. A recent study explored cancer patients’ perspectives on remote patient monitoring for COVID-19 [ 17 ]. Results indicated that patients appreciated that the remote patient monitoring provided a clinical safety net and a link to their clinical team during a period of isolation.…”

Use of home pulse oximetry to enhance remote COVID-19 monitoring: Evaluating a single centre experience

“…This high level of patient acceptance has been previously reported by other studies who have described excellent patient satisfaction with virtual care during the COVID-19 pandemic. 2,[19][20][21][22][23] Aside from the near ubiquitous symptom of cough, dyspnoea was the symptom most frequently identified within the hypoxic group and thus patients reporting dyspnoea as a prominent symptom of their COVID-19 symptom profile should have access to home pulse oximetry. Conversely, cough in the absence of other respiratory symptoms was not a useful predictor of clinical deterioration, hypoxia and escalation to an ED.…”

Analysis of a Remote Monitoring Program for Symptoms Among Adults With Cancer Receiving Antineoplastic Therapy

“…ePRO data were evaluated from October 16, 2018, to February 29, 2020; this cutoff was chosen owing to program changes after this date caused by the COVID-19 pandemic. 27 , 28 The total number of assessments generating alerts and alert severity (red or yellow) by symptom were quantified.…”