Associations between remote patient monitoring programme responsiveness and clinical outcomes for patients with COVID-19

• Type of Material: Article
• Authors: Rebecca Steinberg, Emory University; Bjorn Anderson, Emory University; Ziyue Hu, Emory University; Theodore Johnson II, Emory University; James O'Keefe, Emory University; Laura Plantinga, Emory University; Rishikesan Kamaleswaran, Emory University; Blake Anderson, Emory University
• Language: English
• Date: 2021-09-13
• Publisher: BMJ Publishing Group
• Publication Version: Final Published Version
• Copyright Statement: © Author(s) (or their employer(s)) 2021.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bmjoq-2021-001496
• Title of Journal or Parent Work: BMJ Open Quality
• Volume: 10
• Issue: 3
• Grant/Funding Information: Work of the CARES GWEP is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) as part of Award Number T1MHP39056 totaling US$90 625 with zero percentage financed with non-governmental sources. RS was supported by funding from NIH/NIMHD U54 MD008173 and by the National Centre for Advancing Translational Sciences of the National Institutes of Health under Award Numbers UL1TR002378 and TL1TR002382.
• Keywords: COVID-19; clinical; decision support; telemedicine
• Research Categories: Biology, Virology; Health Sciences, Health Care Management

Abstract

Objective To assess whether engagement in a COVID-19 remote patient monitoring (RPM) programme or telemedicine programme improves patient outcomes. Methods This is a retrospective cohort study analysing patient responsiveness to our RPM survey or telemedicine visits and outcomes during the COVID-19 pandemic. Daily text message surveys and telemedicine consultations were offered to all patients who tested positive for SARS-CoV-2 at our institutional screening centres. Survey respondents with alarm responses were contacted by a nurse. We assessed the relationship between virtual engagement (telemedicine or RPM survey response) and clinical outcomes using multivariable logistic regression. Results Between 10 July 2020 and 2 January 2021, 6822 patients tested positive, with 1230 (18%) responding to at least one survey. Compared with non-responders, responders were younger (49 vs 53 years) and more likely to be white (40% vs 33%) and female (65% vs 55%) and had fewer comorbidities. After adjustment, individuals who engaged virtually were less likely to experience an emergency department visit, hospital admission or intensive care unit–level care. Conclusion Telemedicine and RPM programme engagement (vs no engagement) were associated with better outcomes, but this was likely due to differences in groups at baseline rather than the efficacy of our intervention alone.