Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 5, 2020
Open Peer Review Period: Jun 5, 2020 - Jul 20, 2020
Date Accepted: Mar 1, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Virtual health care for community management of patients with COVID-19.
ABSTRACT
Background:
Virtual health care is emerging as a central strategy to manage large numbers of patients affected by the COVID-19 pandemic, as this can maximise the use of limited clinical resources, reduce pressure on acute facilities and reduce the potential for healthcare-associated infection
Objective:
To describe the implementation and early experience of virtual health care for community management of patients with COVID-19.
Methods:
Design: observational cohort study. Setting: large Australian metropolitan health service with established virtual health care program and remote patient monitoring capability. Participants: patients with COVID-19 living within the health service who can self-isolate safely, do not require immediate admission to an inpatient setting, have no major active comorbid illness and can be managed at home or other suitable accommodation. Main outcome measures: care escalation rates, including hospital admission.
Results:
between 11-29 March 2020, 162/173 (93.6%) locally diagnosed patients with COVID-19 were accepted to the virtual health care program, median age 38y (range 11-79). For the 62 patients discharged during this period the median length of stay was 8 days (range 1-17). The peak of 100 prevalent patients equated to approximately 25 patients per Registered Nurse per shift. Patients were contacted a median of 16 times (range 1-30) during this period, with video consultations used 66.3% of the time; 132/162 (81.5%) patients were monitored remotely. Care escalation rates were low: ambulance attendance, 5 (3%); ED attendance, 4 (2.5%); hospital admission, 3 (1.9%). There were no deaths.
Conclusions:
Community-based virtual health care is feasible for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian context for pandemic management. Health services implementing virtual health care should anticipate challenges with rapid technology deployments and provide adequate support to resolve them including strategies supporting consumer use of health information technologies.
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Copyright
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