Information Technology–Based Management of Clinically Healthy COVID-19 Patients: Lessons From a Living and Treatment Support Center Operated by Seoul National University Hospital

Abstract

Background South Korea took preemptive action against coronavirus disease (COVID-19) by implementing extensive testing, thorough epidemiological investigation, strict social distancing, and rapid treatment of patients according to disease severity. The Korean government entrusted large-scale hospitals with the operation of living and treatment support centers (LTSCs) for the management for clinically healthy COVID-19 patients. Objective The aim of this paper is to introduce our experience implementing information and communications technology (ICT)-based remote patient management systems at a COVID-19 LTSC. Methods We adopted new electronic health record templates, hospital information system (HIS) dashboards, cloud-based medical image sharing, a mobile app, and smart vital sign monitoring devices. Results Enhancements were made to the HIS to assist in the workflow and care of patients in the LTSC. A dashboard was created for the medical staff to view the vital signs and symptoms of all patients. Patients used a mobile app to consult with their physician or nurse, answer questionnaires, and input self-measured vital signs; the results were uploaded to the hospital information system in real time. Cloud-based image sharing enabled interoperability between medical institutions. Korea’s strategy of aggressive mitigation has “flattened the curve” of the rate of infection. A multidisciplinary approach was integral to develop systems supporting patient care and management at the living and treatment support center as quickly as possible. Conclusions Faced with a novel infectious disease, we describe the implementation and experience of applying an ICT-based patient management system in the LTSC affiliated with Seoul National University Hospital. ICT-based tools and applications are increasingly important in health care, and we hope that our experience will provide insight into future technology-based infectious disease responses.

COVID-19 Mobile Apps: A Systematic Review of the Literature

“…For health care professionals, they included information about how to handle patients with COVID-19 [ 31 , 34 ]. One paper [ 25 ] described how the hospital information system was adapted to handle COVID-19 with the incorporation of relevant templates. An app for recording general health information was discussed in 1 paper [ 33 ], and apps for self-assessment focusing on symptoms were found in 1 paper [ 32 ].…”

“…Home monitoring was handled based on telephone outreach [ 29 ], smart vital sign monitoring devices [ 25 ], and Internet of Things [ 27 ]. An interactive map of user demographics and health status was discussed in 1 paper [ 32 ].…”

“…The studies that reported the largest number of users were those described by Drew et al [ 26 ] (over 2 million users) and Menni et al [ 30 ] (2,450,569 users in the United Kingdom and 168,293 from the United States that had reported symptoms through the smartphone app). Studies that reported the lowest number of participants were the ones described by Bae et al [ 25 ] (12 patients and 24 medical staff) and Ben Hassen et al [ 27 ] (5 hospitalized patients and 5 doctors).…”

“…Concerning the follow-up duration (study duration) , 3 out of the 12 selected studies [ 23 , 25 , 27 ], did not report the study duration. Kodali et al [ 28 ] reported the end date but did not mention the start date of app use, Drew et al [ 26 ] reported only the start date of the app launch, Ros and Neuwirth [ 31 ] reported 3 days of app use, Yamamoto et al [ 33 ] reported 14 days, Zamberg et al [ 34 ] reported 18 days, Timmers et al [ 32 ] reported 20 days, and Huckins et al [ 24 ] reported 67 days of app use.…”

“…Additionally, mobiles apps were used for home monitoring, as reported in 4 studies [ 23 , 25 , 27 , 29 ], with satisfactory usability for both patients and health care professionals. These apps were focused on the management of patients who are at high risk, the moderation of exposure risk for health care workers, and the reductions of community spread through appropriate education on home-based care for individuals who are exposed or infected.…”