Home Monitoring Can Improve Health, Ease Anxiety for COVID-19 Patient
Many people who contract the new coronavirus and develop COVID-19 likely won’t need to be hospitalized.
By some estimates, about 15 to 20 percent of people with COVID-19 will need hospitalizationTrusted Source for the disease. The remainder will be able to ride it out at homeTrusted Source with rest, fluids, and fever reducers.
But COVID-19 is a tricky disease.
Even if a patient seems to be improving well on their own, their condition can quickly nosedive and require immediate medical attention.
There are still a lot of unknowns about the disease, and it’s impossible to predict exactly how it will play out in each person.
To better support the thousands of people with COVID-19 recovering at home, a few hospitals have launched home monitoring programs.
These involve healthcare workers checking in with COVID-19 patients daily to track how their infection is progressing.
So far, the home monitoring programs have been a powerful tool in helping COVID-19 patients confidently and comfortably recover at home.
A new report from Northwestern Medicine published this week in the New England Journal of Medicine Catalyst shows that COVID-19 patients who used the home monitoring program felt less frightened about their illness.
Additionally, the program helped healthcare workers detect and escalate care for patients whose conditions were worsening: Of the 7,604 patients monitored, 500 patients were sent to the emergency department.
“We were able to catch these patients before their condition dangerously deteriorated, which improved our ability to treat them,” Dr. Jeffrey Linder, the Northwestern Medicine chief of general internal medicine and geriatrics, said in an emailed statement.
Northwestern University launched their home monitoring program at the end of March.
Linder told Healthline that at the start of the pandemic, his team had been reading all of the data coming out of Wuhan, China, showing that 80 percent of people with COVID-19Trusted Source didn’t need hospital-level care.
“We were trying to figure out a way to take care of that majority of people who were going to care for themselves at home — but in a way that we could keep tabs on them, give them advice, support them, and then escalate care if need be,” Linder said.
In addition, many people who do get severely sick tend to develop concerning symptoms about 5 to 10 days into their illness, and there’s not much you can do ahead of time to prevent a severe course of illness.
But as soon as someone is short of breath, you want to get them to the ER quickly, according to Linder.
“You want somebody to go to the hospital right when they need it and not before — not too early, not too late,” Linder said.
In about a week, the team developed a solution — a home monitoring program for COVID-19 patients.
Within the hospital system’s patient portal, people diagnosed as having COVID-19 or presumed positive for the coronavirus are sent a daily questionnaire in which they rate their symptoms.
Those who don’t fill out the questionnaire along with those who report concerning symptoms, such as confusion or difficulty breathing, are contacted by a healthcare worker — a nurse, physician assistant, medical student, or nurse practitioner — who can further assess the patient’s condition and facilitate a call to 911 if necessary.
Geisinger Health System, based in New Jersey and Pennsylvania, similarly launched a coronavirus home monitoring program in May.
Patients diagnosed with COVID-19 are given a package that includes a mask, pulse oximeter (which measures blood oxygen levels), a digital thermometer, and acetaminophen for pain.
While recovering at home, patients are asked to report their symptoms, temperature, and oxygen levels twice a day via Geisinger’s mobile app.
If a patient’s condition worsens, this alerts a nurse, who then calls the patient, evaluates their symptoms, and facilitates an ambulance transport to the emergency department if necessary.
Dr. Benjamin Hohmuth, a hospitalist and the chief medical informatics officer at Geisinger, says by closely monitoring COVID-19 patients on a daily basis, healthcare workers have been able to intervene early if and when someone develops problematic oxygen levels or severe symptoms.
“Anecdotally, we have a had home monitoring patients directed for hospitalization that wound up rapidly needing ventilatory support in the ICU,” said Hohmuth.
For months, scientists have known very little about the novel coronavirus sweeping the world.
“Patients just get told you have this potentially fatal infection, you have to stay away from everybody else in your house, but you’re probably going to be OK. That’s just a recipe for anxiety,” Linder said.
With the home monitoring tools, nurses and medical workers have been able to address patients’ anxiety about the illness and provide them with information, reassurance, and social support.
“Anxiety is a significant burden for patients with a COVID diagnosis, and home monitoring whether telephonic or digital definitely helps mitigate some of the emotional impact,” Hohmuth said.
Most importantly, it’s helped identify COVID-19 patients experiencing a sudden, severe decline and get them to the emergency department quickly before it’s too late.
“Would they have come to the [emergecy department] on their own?” Hohmuth said. “Hopefully.”
A few hospitals have launched home monitoring programs in which healthcare workers check in with COVID-19 patients on a daily basis to track how their infection is progressing.
A new report from Northwestern Medicine shows that in addition to helping patients feel less frightened about their illness, home monitoring has helped catch a number of patients whose symptoms have rapidly declined and required immediate transport to the emergency room.