Remote patient monitoring to interrupt chains of respiratory infections in outpatient care - a case-control study during the 2020/21 infection season

Abstract

Aim of the study The aim of the study was to investigate satisfaction, saving of time and the possible reduction of patient visits to practices that use Remote Patient Monitoring (RPM) during treatment compared to usual care. Methods In a case-control study between October 2020 and May 2021, the participating practices were randomized into three groups (two different RPM systems, one control). The doctors were required to enroll patients with acute respiratory infection ≥ 18 years who have a web-enabled device. After a three-month study phase, the doctors were asked to describe the treatment of their patients via online survey. The patients were also questioned. The analysis was carried out descriptively and with group comparisons. Results 51 practices with 121 patients were included. Overall, the results show a positive assessment of digital care on the patient side. As for the doctors, handling and integration of the systems into consisting practice processes seem to be a challenge. Further, the number of patient visits to the practice was not reduced by using the systems and the doctors did not save time, but the relationship to the patients was intensified. Conclusion Even if there were no indications for more efficiency by using the RPM systems, the doctors see great potential to intensify the interaction between doctor and patient. In particular, more intensive contact with patients with chronic diseases (e. g. COPD, long-COVID) could be of long term interest and importance for doctors in outpatient care. Trial Registration: DRKS00023553 Keywords: RPM, outpatient care, chains of infection, respiratory infection

Health care professionals’ perspectives on the utilisation of a remote surveillance and care tool for patients with COVID-19 in general practice: a qualitative study

“…Considering other prerequisites that enable an easy integration into daily practice and therefore the utilisation of a tool, previous research underscored that it is crucial that monitoring and surveillance data can be integrated into the existing practice management software [7,8,12], which is in line with our findings.…”

“…Another study on remote patient monitoring of infectious patients in ambulatory care found that participating practices identified the integration of the monitoring tools as a main obstacle and could not benefit from a lower workload, which is somewhat in line with our findings on perceived barriers [8]. However, we explored that CovidCare led to a shift of resources: while VERAHs perceived additional workload as negative, GPs highlighted a relief of their resources as positively impacting the utilisation of CovidCare.…”

“…Telehealth approaches are primed to enable HCP to provide virtual care for COVID-19 patients and patients with regular health issues and can be an effective way of treatment [3][4][5]. There are many different models for the remote management of COVID-19 patients in longterm care facilities [6], hospitals [7] and practices [8], e.g. including symptom tracking by HCP or the patients themselves, remote monitorings and follow-ups.…”

“…to support HCP in collecting data on the health status of patients who are self-managing [9,10] in homequarantine, have also been developed [11][12][13] and can support HCP in the early detection of deterioration [6,10]. Evaluations of these models points to several crucial perquisites for the remote management of COVID-19 patients such as the integration of the patients' data into softwares used in general practices [7,8] to reduce workload and foster implementation, as well as a close contact between the patients and the doctors especially for high risk patients with chronic diseases [8]. Furthermore, previous work highlight the use of a symptom diary as particularly useful for the management of COVID-19 patients [9].…”