Use of eHealth Platforms and Apps to Support Monitoring and Management of Home-Quarantined Patients With COVID-19 in the Province of Trento, Italy: App Development and Implementation

Abstract

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.

Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19

“…In Italy, in the course of the first wave of the COVID-19 pandemic, available telehealth solutions have been used to track and promptly detect potentially infected individuals [ 14 , 15 ] and monitor patients with any critical chronic condition (including heart failure, diabetes, oncological disease, skin disease, neurological or psychiatric disease, immunological disease) restrained at home [ 16 – 22 ]. However, preliminary reports suggest that the Country was mostly unprepared to implement existing telehealth solutions for this purpose [ 11 , 23 – 26 ].…”

Telemedicine technologies and applications in the era of COVID-19 pandemic: A systematic review

“…Mobile apps are also used for telehealth visits or electronic visits. 44 , 46 , 50 Telemedicine application software companies utilize app connectivity and cloud technologies to grant real-time distant patient follow-up, monitoring, visiting and consulting. It saves time for both patients and physicians by monitoring health progress.…”

Health care professionals’ perspectives on the utilisation of a remote surveillance and care tool for patients with COVID-19 in general practice: a qualitative study

“…A study on an app to provide HCP with a software to remotely monitor COVID-19 patients in home-quarantine found that the app reduced paperwork for HCP because patients self-assessed their health status [11]. Still, HCP spend additional time on assisting patients in activating and using the app.…”

“…Besides, apps, e.g. to support HCP in collecting data on the health status of patients who are self-managing [9,10] in homequarantine, have also been developed [11][12][13] and can support HCP in the early detection of deterioration [6,10]. Evaluations of these models points to several crucial perquisites for the remote management of COVID-19 patients such as the integration of the patients' data into softwares used in general practices [7,8] to reduce workload and foster implementation, as well as a close contact between the patients and the doctors especially for high risk patients with chronic diseases [8].…”