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Adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with COVID-19: a descriptive study

BACKGROUND: Virtual care for patients with coronavirus disease 2019 (COVID-19) allows providers to monitor COVID-19-positive patients with variable trajectories while reducing the risk of transmission to others and ensuring health care capacity in acute care facilities. The objective of this descrip...

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Autores principales: Agarwal, Payal, Mukerji, Geetha, Laur, Celia, Chandra, Shivani, Pimlott, Nick, Heisey, Ruth, Stovel, Rebecca, Goulbourne, Elaine, Bhatia, R. Sacha, Bhattacharyya, Onil, Martin, Danielle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Joule Inc. or its licensors 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034257/
https://www.ncbi.nlm.nih.gov/pubmed/33795222
http://dx.doi.org/10.9778/cmajo.20200174
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author Agarwal, Payal
Mukerji, Geetha
Laur, Celia
Chandra, Shivani
Pimlott, Nick
Heisey, Ruth
Stovel, Rebecca
Goulbourne, Elaine
Bhatia, R. Sacha
Bhattacharyya, Onil
Martin, Danielle
author_facet Agarwal, Payal
Mukerji, Geetha
Laur, Celia
Chandra, Shivani
Pimlott, Nick
Heisey, Ruth
Stovel, Rebecca
Goulbourne, Elaine
Bhatia, R. Sacha
Bhattacharyya, Onil
Martin, Danielle
author_sort Agarwal, Payal
collection PubMed
description BACKGROUND: Virtual care for patients with coronavirus disease 2019 (COVID-19) allows providers to monitor COVID-19-positive patients with variable trajectories while reducing the risk of transmission to others and ensuring health care capacity in acute care facilities. The objective of this descriptive analysis was to assess the initial adoption, feasibility and safety of a family medicine–led remote monitoring program, COVIDCare@Home, to manage the care of patients with COVID-19 in the community. METHODS: COVIDCare@Home is a multifaceted, interprofessional team–based remote monitoring program developed at an ambulatory academic centre, the Women’s College Hospital in Toronto. A descriptive analysis of the first cohort of patients admitted from Apr. 8 to May 11, 2020, was conducted. Lessons from the implementation of the program are described, focusing on measure of adoption (number of visits per patient total, with a physician or with a nurse; length of follow-up), feasibility (received an oximeter or thermometer; consultation with general internal medicine, social work or mental health, pharmacy or acute ambulatory care unit) and safety (hospitalizations, mortality and emergency department visits). RESULTS: The COVIDCare@Home program cared for a first cohort of 97 patients (median age 41 yr, 67% female) with 415 recorded virtual visits. Patients had a median time from positive testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to first appointment of 3 (interquartile range [IQR] 2–4) days, with a median virtual follow-up time of 8 (IQR 5–10) days. A total of 4 (4%) had an emergency department visit, with no patients requiring hospitalization and no deaths; 16 (16%) of patients required support with mental and social health needs. INTERPRETATION: A family medicine–led, team-based remote monitoring program can safely manage the care of outpatients diagnosed with COVID-19. Virtual care approaches, particularly those that support patients with more complex health and social needs, may be an important part of ongoing health system efforts to manage subsequent waves of COVID-19 and other diseases.
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spelling pubmed-80342572021-04-16 Adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with COVID-19: a descriptive study Agarwal, Payal Mukerji, Geetha Laur, Celia Chandra, Shivani Pimlott, Nick Heisey, Ruth Stovel, Rebecca Goulbourne, Elaine Bhatia, R. Sacha Bhattacharyya, Onil Martin, Danielle CMAJ Open Research BACKGROUND: Virtual care for patients with coronavirus disease 2019 (COVID-19) allows providers to monitor COVID-19-positive patients with variable trajectories while reducing the risk of transmission to others and ensuring health care capacity in acute care facilities. The objective of this descriptive analysis was to assess the initial adoption, feasibility and safety of a family medicine–led remote monitoring program, COVIDCare@Home, to manage the care of patients with COVID-19 in the community. METHODS: COVIDCare@Home is a multifaceted, interprofessional team–based remote monitoring program developed at an ambulatory academic centre, the Women’s College Hospital in Toronto. A descriptive analysis of the first cohort of patients admitted from Apr. 8 to May 11, 2020, was conducted. Lessons from the implementation of the program are described, focusing on measure of adoption (number of visits per patient total, with a physician or with a nurse; length of follow-up), feasibility (received an oximeter or thermometer; consultation with general internal medicine, social work or mental health, pharmacy or acute ambulatory care unit) and safety (hospitalizations, mortality and emergency department visits). RESULTS: The COVIDCare@Home program cared for a first cohort of 97 patients (median age 41 yr, 67% female) with 415 recorded virtual visits. Patients had a median time from positive testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to first appointment of 3 (interquartile range [IQR] 2–4) days, with a median virtual follow-up time of 8 (IQR 5–10) days. A total of 4 (4%) had an emergency department visit, with no patients requiring hospitalization and no deaths; 16 (16%) of patients required support with mental and social health needs. INTERPRETATION: A family medicine–led, team-based remote monitoring program can safely manage the care of outpatients diagnosed with COVID-19. Virtual care approaches, particularly those that support patients with more complex health and social needs, may be an important part of ongoing health system efforts to manage subsequent waves of COVID-19 and other diseases. Joule Inc. or its licensors 2021-03-30 /pmc/articles/PMC8034257/ /pubmed/33795222 http://dx.doi.org/10.9778/cmajo.20200174 Text en © 2021 Joule Inc. or its licensors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Research
Agarwal, Payal
Mukerji, Geetha
Laur, Celia
Chandra, Shivani
Pimlott, Nick
Heisey, Ruth
Stovel, Rebecca
Goulbourne, Elaine
Bhatia, R. Sacha
Bhattacharyya, Onil
Martin, Danielle
Adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with COVID-19: a descriptive study
title Adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with COVID-19: a descriptive study
title_full Adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with COVID-19: a descriptive study
title_fullStr Adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with COVID-19: a descriptive study
title_full_unstemmed Adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with COVID-19: a descriptive study
title_short Adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with COVID-19: a descriptive study
title_sort adoption, feasibility and safety of a family medicine–led remote monitoring program for patients with covid-19: a descriptive study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034257/
https://www.ncbi.nlm.nih.gov/pubmed/33795222
http://dx.doi.org/10.9778/cmajo.20200174
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