Oncology patients’ perspectives on remote patient monitoring for COVID-19.

Abstract

1504 Background: Oncology patients are particularly vulnerable to adverse outcomes from COVID-19 and require careful monitoring to identify early deterioration and render higher level care when indicated. Several institutions launched remote patient monitoring programs (RPMPs) to care for patients with COVID-19. We describe patients’ perspectives on a COVID-19 RPMP at a National Comprehensive Cancer Center. Methods: Adult patients who had either tested positive for COVID-19 on an outpatient microbiology test or were discharged after hospitalization for the virus were eligible. Patients enrolled in the RPMP received a daily 10-question electronic patient-reported outcome assessment of COVID-19 symptoms and their responses generated alerts to a centralized monitoring team for new or worsening symptoms. A subset of high-risk patients also received a pulse oximeter which alerted when blood oxygen levels dropped below 93%. RPM was discontinued 14 days after a patient’s positive test result and following 3 days without worsening symptoms or fever. Patients who exited the program and had completed at least one assessment were sent a patient engagement survey. The objective of the survey was to evaluate the patient’s experience with digital monitoring and symptom management for COVID-19. The assessment was structured with objective response questions, including a net promoter score, and free text questions to elicit patient perspectives on RPM value. Free text responses were analyzed using grounded theory to identify primary themes regarding perceived value. Results: The survey was distributed to 452 patients; 241 responded as of June 10, 2020 (53% completion rate). The net promoter score was 91%. The table provides responses to objective questions. Qualitative analysis of free text responses identified the primary themes regarding patient perceived value which included: 1) Security: patients appreciated that the RPMP provided a clinical safety net; 2) Connection: patients appreciated the link to their clinical team during a period of isolation; 3) Empowerment: patients appreciated that the RPMP provided education on the virus and symptom management. Conclusions: RPMPs are perceived to be of value to oncology patients with COVID-19. A key barrier to maintaining these programs is cost. Policymakers should consider how these programs can be reimbursed in the future so that they can continue to provide care to vulnerable patients and keep them at home out of the acute care setting.[Table: see text]

Impact of remote vital sign monitoring on health outcomes in acute respiratory infection and exacerbation of chronic respiratory conditions: systematic review and meta-analysis

“…While using remote monitoring, patients appreciate if the intervention provides security (clinical safety net), connection (link to their clinical team), empowerment (education on the disease and symptom management), user-friendliness (ease of access to services), and continuity of care provided. However, patients show concerns about additional burden (reluctance to learn something new, lack of trust in technology, avoiding additional out-of-pocket costs) and jeopardising interpersonal connections (fear of being lost in data, losing face to face contact) [30][31][32]. Future studies might consider a core-outcome set to help reviews.…”

Association Between Remote Monitoring and Acute Care Visits in High-Risk Patients Initiating Intravenous Antineoplastic Therapy

“…We planned to perform a randomized trial but our resources were redirected during the pandemic to remotely monitor patients with COVID-19 disease. 18,19 The patients also were predominantly White and the practice settings drew from affluent neighborhoods, which could limit the generalizability of the findings. Second, a centralized team for A 0 1 2 3 remote monitoring might be cost-prohibitive to some practices.…”

COVID19 in hematological patients and telemedicine: lessons learned across Europe and the US

“…The authors reported feasibility of RPM for management of COVID19 patients, a relatively high degree of patient engagement, and reported ease of access to electronic and clinical assessment tools by patients [27 & ]. Oncologic patient perceptions on a RPM program for COVID19 infection were evaluated in a moderately-sized cohort of patients in a single oncologic center in the USA [28]. The program consisted of enrollment of patients with recently diagnosed COVID19 infection, daily electronic symptom assessment, distribution of pulse oximeters to a subset of high-risk patients, patient education about worsening symptoms, a team of physicians, advanced practice practitioners and nurses that assessed results of the clinical data, and a standardized response to clinical assessment.…”