Hospital workers have a lot to contend with during the COVID-19 crisis — a shortage of PPE, surge capacity, exhausting hours, and the heartbreaking loss of patients in numbers too overwhelming to comprehend.
COVID-19 has fundamentally altered intensive care workflows. Healthcare workers are stretched far beyond their limits and every minute is precious. Those minutes are needed at the bedside and time must be made for the healthcare provider to hydrate, eat, and take a moment to recharge. As we face this new reality, calling the ever-increasing numbers of patients with test results and self-care information is just not scalable using traditional means.
Here are some ways hospitals are rapidly escalating of new workflows for patient monitoring:
Monitor COVID-19 (+) Patients
As testing for COVID-19 becomes more prevalent, rapid communication of test results and longitudinal monitoring of symptoms is a critical component of crisis management. Patients who test positive for COVID-19 and are not admitted to the hospital should be monitored at home for symptom progression. By proactively collecting this information, health professionals can intervene before an adverse event occurs, as well as gain valuable insights that can help the rest of the community with containment and contact tracing, both essential next steps in pandemic management.
Monitor COVID-19 (-) Patients and Persons Under Investigation (PUI)
Considering that even those who are asymptomatic could spread the disease, it’s also critical to follow up with and monitor patients who test negative. Through monitoring, these patients should be asked questions about potential onset of symptoms and be provided with education on recommended practices that can minimize their either catching, or spreading, the virus. Monitoring these persons under investigation (PUIs) is critical to assessing if they may be at risk for further spreading the disease and whether they qualify for additional testing or treatment.
Symptom progression can occur rapidly and ensuring these patients know when and how to seek hospital care can potentially save lives.
Use Automated Outreach to Monitor Patients
Automated outreach is an efficient and scalable method to monitor patients at frequent intervals. Providers should leverage a mix of automated calls and text messages to ensure that patients are more likely to engage and answer questions about their symptoms, especially for elderly patients who might be at a higher risk for poor clinical outcomes.
CipherHealth is partnering with health systems across the country to implement these longitudinal monitoring programs. Patients who test positive receive automated daily texts for two weeks asking them about symptom progression, along with education on how to minimize virus spread. If symptoms worsen, a provider reaches out directly to the patient either by phone or leveraging telehealth to rapidly assess the patient’s condition.
After two weeks of daily texting with no worsening of symptoms that require hospital care, patients receive automated weekly texts for four more weeks. This helps to capture additional information on how long symptoms last and if they continue to progress after the two-week quarantine period.
For patients who test negative, CipherHealth provides automated texts to assess for symptom progression every three days, for two weeks. Similar to patients who test positive, these PUIs continue to receive weekly automated texts for an additional four weeks.
Early Results for Longitudinal Monitoring
Initial results demonstrate the willingness of patients to engage during this time. For one program administered by CipherHealth, patients who tested negative engaged with more than 90% of the automated follow-up calls and texts. Approximately 9% of those who interacted with the program reported an issue, such as worsening symptoms, which was immediately escalated to the healthcare provider for direct follow up by phone.
Programs like this help to keep the call volume manageable for the system’s staffing resources, helping to preserve precious time at the bedside and allowing for careful attention to PPE and essential self-care regimens.
As they work tirelessly to save patients in acute respiratory distress, healthcare workers also worry about getting sick themselves. They fear spreading the virus to their family and friends as they balance high-stress situations with taking the time to adequately protect themselves. Staff self-protection must not be sacrificed for a laser focus on intensive patient care, especially when there are ways to complete tasks that can alleviate some of these stresses.
Longitudinal monitoring of patients, post-testing, combined with proactive screening and broadcast messaging to communities, creates a powerful crisis response workflow that slows the spread of COVID-19, while connecting patients with life-saving resources quickly and effectively. Automation of this workflow ensures the process is scalable and able to handle the large numbers of patients affected by this deadly virus.
Download our complete report “COVID-19 Crisis Response Bundle: Patient Care – Patient Monitoring Program”.