Virtual Health Care for Community Management of Patients With COVID-19 in Australia: Observational Cohort Study

Autor: Lau, Annie, Muhammad, Faisal, Mircheva, Iskra, Goniewicz, Krzysztof, Adly, Mahmoud, Adly, Aya, Adly, Afnan, da Graca Pimentel, Maria, Hutchings, Owen Rhys, Dearing, Cassandra, Jagers, Dianna, Shaw, Miranda Jane, Raffan, Freya, Jones, Aaron, Taggart, Richard, Sinclair, Tim, Anderson, Teresa, Ritchie, Angus Graham
Rok vydání: 2021
Předmět:
Male
020205 medical informatics
Remote patient monitoring
02 engineering and technology
Telehealth
Health informatics
Cohort Studies
0302 clinical medicine
Health care
0202 electrical engineering
electronic engineering
information engineering
informatics
Medicine
Community Health Services
030212 general & internal medicine
Child
lcsh:Public aspects of medicine
health
Middle Aged
Patient Discharge
Telemedicine
Hospitalization
lcsh:R858-859.7
Female
Medical emergency
Emergency Service
Hospital
Cohort study
Adult
Adolescent
telehealth
virtual health care
digital health
Health Informatics
lcsh:Computer applications to medicine. Medical informatics
Young Adult
03 medical and health sciences
Humans
Pandemics
remote monitoring
Aged
Monitoring
Physiologic
Original Paper
SARS-CoV-2
business.industry
Australia
COVID-19
lcsh:RA1-1270
Emergency department
medicine.disease
Digital health
Coronavirus
business
Medical Informatics
Zdroj: Journal of Medical Internet Research
Journal of Medical Internet Research, Vol 23, Iss 3, p e21064 (2021)
ISSN: 1438-8871
DOI: 10.2196/21064
Popis: Background Australia has successfully controlled the COVID-19 pandemic. Similar to other high-income countries, Australia has extensively used telehealth services. Virtual health care, including telemedicine in combination with remote patient monitoring, has been implemented in certain settings as part of new models of care that are aimed at managing patients with COVID-19 outside the hospital setting. Objective This study aimed to describe the implementation of and early experience with virtual health care for community management of patients with COVID-19. Methods This observational cohort study was conducted with patients with COVID-19 who availed of a large Australian metropolitan health service with an established virtual health care program capable of monitoring patients remotely. We included patients with COVID-19 who received the health service, could self-isolate safely, did not require immediate admission to an in-patient setting, had no major active comorbid illness, and could be managed at home or at other suitable sites. Skin temperature, pulse rate, and blood oxygen saturation were remotely monitored. The primary outcome measures were care escalation rates, including emergency department presentation, and hospital admission. Results During March 11-29, 2020, a total of 162 of 173 (93.6%) patients with COVID-19 (median age 38 years, range 11-79 years), who were diagnosed locally, were enrolled in the virtual health care program. For 62 of 162 (38.3%) patients discharged during this period, the median length of stay was 8 (range 1-17) days. The peak of 100 prevalent patients equated to approximately 25 patients per registered nurse per shift. Patients were contacted a median of 16 (range 1-30) times during this period. Video consultations (n=1902, 66.3%) comprised most of the patient contacts, and 132 (81.5%) patients were monitored remotely. Care escalation rates were low, with an ambulance attendance rate of 3% (n=5), emergency department attendance rate of 2.5% (n=4), and hospital admission rate of 1.9% (n=3). No deaths were recorded. Conclusions Community-based virtual health care is safe for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian setting for pandemic management. Health services implementing virtual health care should anticipate challenges associated with rapid technology deployments and provide adequate support to resolve them, including strategies to support the use of health information technologies among consumers.
Databáze: OpenAIRE
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