Virtual health care for community management of patients with COVID-19.

Hutchings, Owen; Dearing, Cassandra; Jagers, Dianna; Shaw, Miranda; Raffan, Freya; Jones, Aaron; Taggart, Richard; Sinclair, Tim; Anderson, Teresa; Ritchie, Angus

doi:10.1101/2020.05.11.20082396

Cited by 19 publications

(23 citation statements)

References 18 publications

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“…17 Virtual primary health care allows the safe management of mild cases of COVID-19. 18 Hong et al used internet volume data from Google Trends to measure population-level interest in telehealth and telemedicine during the time of COVID-19. The authors found that the population's interest in the United States in telehealth was high when the number of COVID-19 cases increased.…”

Section: E-health Supporting Team Care Measurement and Clinical Decmentioning

confidence: 99%

Applications of e-Health to Support Person-Centered Health Care at the Time of COVID-19 Pandemic

Tebeje

Klein

2021

Telemedicine and e-Health

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Background: Many e-health services were launched after countries relaxed their telehealth regulations to combat the coronavirus disease 2019 (COVID-19) pandemic. e-Health technologies that support person-centered health care are crucial for the patient's needs. In this systematic review, we examined how e-health applications are used to support person-centered health care at the time of COVID-19. Methodology: Literature was systematically searched without language restriction and publication status between January 1 and May 25, 2020, to describe e-health's support on the person-centered health care to control the COVID-19 pandemic. PubMed, ScienceDirect, and CINAHL, MedRxiv, and Web of Science were used. Two researchers independently assessed the eligibility of each retrieved record. All included studies were subsequently rescreened by the researchers. The systematic review was conducted in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines. Results: We identified 60 articles and selected 8 studies that met the inclusion criteria. Most of the studies used e-health technologies to facilitate clinical decision support and team care. Patient's engagement and access to health care from their homes were enhanced using telehealth and mobile health. Electronic health records were used to avail reliable data to health care providers and health authorities to make evidence-based decisions. Conclusion: Although there are limited studies to evaluate the effectiveness of e-health technologies for person-centered health care, the reviewed studies indicated e-health's potentials to improve the quality of health care and personalized health systems during COVID-19 pandemic. Further research should be done to better understand applications of e-health to improve the quality of health care and patients' outcomes and evaluate its cost-effectiveness.

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Section: E-health Supporting Team Care Measurement and Clinical Decmentioning

confidence: 99%

Applications of e-Health to Support Person-Centered Health Care at the Time of COVID-19 Pandemic

Tebeje

Klein

2021

Telemedicine and e-Health

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“…What are the expected outcomes of implementing remote home monitoring? 6. What is their impact on outcomes and costs?…”

Section: Research Questionsmentioning

confidence: 99%

“…Shah et al 16 followed-up patients on their pre-admission pathway for 7 days. Hutchings et al 6 referred patients to their GP for follow-up after discharging them from the remote home monitoring pathway.…”

Section: Stages Of Remote Home Monitoringmentioning

confidence: 99%

“…Remote home monitoring models have been implemented in the US, Australia, Canada, the Netherlands, Ireland, China and UK, with some variation in the frequency of patient monitoring, modality (a combination of telephone or video calls and use of applications or online portals), patient admission criteria, staffing models used for patient monitoring and level of clinical oversight, and use of pulse oximetry [4][5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

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Remote home monitoring (virtual wards) during the COVID-19 pandemic: a systematic review

Vindrola‐Padros

et al. 2020

Preprint

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Objectives: The aim of this review was to analyse the implementation and impact of remote home monitoring models (virtual wards) during COVID-19, identifying their main components, processes of implementation, target patient populations, impact on outcomes, costs and lessons learnt. Design: The review was designed as a rapid systematic review to capture an evolving evidence base. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Setting: The review included models led by primary and secondary care across seven countries. Participants: 17 examples of models were included in the review. Main outcome measures: Impact of remote home monitoring on virtual length of stay, escalation, emergency department attendance/reattendance, admission/readmission and mortality. Results: The aim of the models was to maintain patients safe in the right setting. Most models were led by secondary care and confirmation of COVID-19 was not required (in most cases). Monitoring was carried via online platforms, paper-based systems with telephone calls or (less frequently) through wearable sensors. Models based on phone calls were considered more inclusive. Patient/carer training was identified as a determining factor of success. We could not reach conclusions regarding patient safety and the identification of early deterioration due to lack of standardised reporting and missing data. Economic analysis was not reported beyond how the resources were used. Conclusions: Future research should focus on staff and patient experiences of care and inequalities in patients access to care. Attention needs to be paid to the cost-effectiveness of the models and their sustainability, evaluation of their impact on patient outcomes by using comparators and the use of risk-stratification tools. Protocol registration: The review protocol was published on PROSPERO (CRD: 42020202888).

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“…temperature), seek to remotely monitor patients considered at high-risk of deterioration at home to: 1) avoid unnecessary hospital admissions and promote appropriate admissions (appropriate care at the appropriate place), and 2) escalate cases of deterioration at an earlier stage to avoid invasive ventilation and ICU admission (by referring patients to emergency services or asking them to visit primary care) 3 . Remote home monitoring models have been implemented for confirmed or suspected COVID-19 cases in the US, Australia, Canada, Ireland, China, The Netherlands, India and the UK, with some variation in the frequency of patient monitoring, modality (telephone or video calls and use of applications or online portals), staffing, patient criteria and use of pulse oximetry to measure oxygen saturation levels [4][5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

The implementation of remote home monitoring models during the COVID-19 pandemic in England

Vindrola‐Padros

Sidhu

Georghiou

et al. 2020

Preprint

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ObjectiveThere is a paucity of evidence for the implementation of remote home monitoring for COVID-19 infection. The aims of this study were to: identify the key characteristics of remote home monitoring models for COVID-19 infection, explore the experiences of staff implementing these models, understand the use of data for monitoring progress against outcomes, and document variability in staffing and resource allocation.MethodsThis was a multi-site mixed methods study that combined qualitative and quantitative approaches to analyse the implementation and impact of remote home monitoring models during the first wave of the COVID-19 pandemic (March to August 2020). The study combined interviews (n=22) with staff delivering these models across eight sites in England with the collection and analysis of data on staffing models and resource allocation.ResultsThe models varied in relation to the healthcare settings and mechanisms used for patient triage, monitoring and escalation. Implementation was embedded in existing staff workloads and budgets. Good communication within clinical teams, culturally-appropriate information for patients/carers and the combination of multiple approaches for patient monitoring (app and paper-based) were considered facilitators in implementation. The mean cost per monitored patient varied from £400 to £553, depending on the model.ConclusionsIt is necessary to provide the means for evaluating the effectiveness of these models, for example, by establishing comparator data. Future research should also focus on the sustainability of the models and patient experience (considering the extent to which some of the models exacerbate existing inequalities in access to care).STRENGTHS AND LIMITATIONS OF THE STUDYThe study makes a contribution to existing evidence on remote home monitoring models by exploring the design and implementation of these models for confirmed or suspected COVID-19 cases.The study was carried out across eight remote home monitoring models implemented in England, capturing variability in the mechanisms used for triage, monitoring and escalation.Limited evidence was available to assess the effectiveness of the remote home monitoring models.No comparator data were available for the absence of remote home monitoring.The study was designed as a rapid evaluation and only captured experiences and processes of implementation in a convenience sample of eight models implemented during the first wave of the pandemic in England.

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Virtual health care for community management of patients with COVID-19.

Cited by 19 publications

References 18 publications

Applications of e-Health to Support Person-Centered Health Care at the Time of COVID-19 Pandemic

Applications of e-Health to Support Person-Centered Health Care at the Time of COVID-19 Pandemic

Remote home monitoring (virtual wards) during the COVID-19 pandemic: a systematic review

The implementation of remote home monitoring models during the COVID-19 pandemic in England

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