JMIR Publications

ABSTRACT

Background:

As part of the ‘Netzwerk Universitaetsmedizin’ cooperation in Germany, non-supervised home monitoring without the support of a virtual ward has been established in various patient care settings (primary care practices / rehabilitation center / emergency department in tertiary care). On a trial basis, we strived for an approach for pandemic management and preparedness in the current health care system. Here we report our lessons learned and a viewpoint on home monitoring delivered through the emergency department from the perspective of a tertiary care provider.

Objective:

This article presents our experiences, lessons learned, and viewpoint on home monitoring delivered through the emergency department in outpatient COVID-19 patients from the perspective of a tertiary care provider.

Methods:

We offered patients who had been tested positive for SARS-CoV-2 and received acute care in the outpatient setting the opportunity to perform a non-supervised home monitoring using Bluetooth-enabled devices (temperature, oxygen saturation and blood pressure measuring sensors) and a smartphone app. After inclusion, the patients were encouraged to measure their vital signs for at least 28 days. The collected data could be made available for regular treatment by the patient, provided by appropriate primary care physicians or the customary ambulatory healthcare system. After the end of the study phase, patients were contacted for a semi-structured interview.

Results:

Between May 2021 and May 2022, 828 patients with COVID-19 were treated at our emergency department. 262 patients were directly discharged after initial assessment into ambulatory isolation. 25 patients were offered the opportunity of non-supervised home monitoring. 15 persons successfully activated the devices and 9 patients from this group performed more than one measurement using the app. These 9 patients used the devices for 15.8 days on average. The patients reached for interviews reported various difficulties to set up the devices but were very pleased to use the home monitoring concept and experienced the measurement option as an additional security.

Conclusions:

Providing non-supervised home monitoring to COVID-19 outpatients through a single contact in an emergency department of a tertiary hospital without additional personnel is not the optimal approach. Overall, physician-patient relationship seems to be a critical success factor for patient-led home monitoring in acute COVID-19. Clinical Trial: The study was registered at the German Clinical Trials Register (ID DRKS00025123).