Kamil Agi, Ph.D., President & CEO of SensorComm Technologies, co-authored this White Paper on Remote Patient Monitoring for COVID-19.
In the midst of the expanding healthcare crisis and uncertainty relating to the Coronavirus (i.e. COVID-19), there are a number of strategies that will help prevent or curb the epidemic in the US. The most effective solutions may include:
Remote screening and monitoring of patients that may be at high risk of exposure
Sequestration or quarantine of exposed patients with remote physiologic monitoring (RPM)
Virtual medical consultations via telemedicine by a Qualified Healthcare Professional (QHCP) to avoid unnecessary public and/or healthcare system exposure
These are all focused on the data-centric care™ model where patients are directly accountable for participating in their care. Personal sequestration or quarantine will help significantly to reduce the spread of the virus if an individual is at high risk of exposure, whether symptomatic or not. The question is whether or not we can determine if an individual will become symptomatic without having them arrive at an urgent care facility or emergency room, putting not only themselves and other patients at risk, but also the healthcare workers. One proposed solution is to utilize remote patient monitoring and telehealth evaluation by a QHCP for initial patient evaluation and interview. If these steps can be taken, we significantly reduce the spread of the disease.
SOLUTION: To utilize existing hardware and software technology, coupled with direct patient education, to provide Remote Physiologic Monitoring (RPM) services and virtual medical consultations. The solution will provide:
Deployment of appropriate handheld devices (e.g., tablet) loaded with appropriate software-enabled technology, as well as appropriate RPM hardware (thermometers, sphygmomanometers, etc.) directly to the patient’s home
Patient instruction on usage of equipment through direct phone and internet education with medical personnel (national call center)
Daily RPM services (temperature twice daily, BP monitoring, etc.) automatically transmitted for automated monitoring, analysis and reporting
Software programmed parameters will alert physician-supervised medical personnel of physiologic data points that fall outside programmed “normal” values and outliers will be reported for further evaluation
Call center personnel will contact “at-risk” patients to gather more pertinent medical information to share with the patient’s medical team
If needed, evaluation by a Qualified Healthcare Professional (QHCP) will be obtained via telemedicine technology
Use the existing remote physiologic monitoring (RPM) platform being developed now can include a wireless thermometer modality. The thermometer would be connected wirelessly to the tablet and/or smartphone. This tablet or smartphone would then re-transmit the data to a central database where the data can be monitored, analyzed and reported.
The patient would periodically (e.g. twice a day) take their temperature and blood pressure. This temperature information would be sent to a database for analysis and reporting. If the individual appears to have a temperature recorded above a set “norm”, a call center would be alerted. The call center would then establish communication between the patient and a qualified healthcare professional (QHCP) via telemedicine. The QHCP would then interview and evaluate the patient to see whether the patient should be sent to an urgent care facility, emergency room or remain under “remote” care. The QHCP can also request that the patient take their temperature in fixed intervals (e.g. hourly or every four hours during the day) and remotely monitor additional vital signs (e.g. blood pressure) to give a better idea of the evolution of the virus attack.
SHORT TERM VERSUS LONG TERM IMPLICATIONS
The short-term implication is that the virus can be better contained by not allowing someone with a compromised immune system (e.g. patients with just a cold and not COVID-19) to go out in public. In addition, by treating the patient at home reduces the risk of the patient spreading the virus unknowingly, keeping the healthcare workers safer. Finally, monitoring the individual at home will provide for less congestion in hospital emergency rooms, where during an epidemic, can be overcrowded and unmanageable leading to significant cost of care.
The long-term implication is that RPM can be implemented by the Housing and Urban Development department as improved care in disadvantaged communities. This can include local health clinics where individuals can login and monitor their own physiological parameters and have access to a virtual QHCP. The clinics can also provide units to patients in the community on short term basis for use at home. In addition, the modality hardware can be provided to the individuals in the community and interfaced through existing personal tablet device or smartphones through an application (i.e. app). These will all include national level call center support, internet-based training through videos and also (potentially) a video support capability, like live workshops.
The long-term focus is based on educating the public, and leveraging technology to provide the necessary tools to participate in data-centric-care™.
*This White Paper was prepared for Echo World Comm, Inc. Kamil Agi, Ph.D.1, Dr. Chris Morrison2, Kristen Muzzy3
1SensorComm Technologies, Inc. 2Mgroup Healthcare Strategies, LLC 3Echo World Comm, Inc.*
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