Web-based, rapid and contactless management of ambulatory patients for SARS-CoV-2-testing

Stemler, Jannik; Cornely, Oliver A.; Noack-Schönborn, Torsten; Fohrholz, Corinna; Schumacher, Sofie; Poluschkin, Leonard; Binder, Bernd R.; Lehmann, Clara; Langebartels, Georg

doi:10.1186/s12879-021-06249-7

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…Every participating HCW and visitor was registered via the “UHC Corona Web Tool” (Healex GmbH, Cologne, Germany), a browser-based smartphone application that, among other functions, records recent history of symptoms and includes an informed consent form for anonymous data utilization [ 18 ]. During the login process, personal data are entered, and a QR code is created to register an individual into the UHC electronic patient chart (ePA) (ORBIS®, Dedalus Healthcare Group, Bonn, Germany) and allow automated test result delivery via text message.…”

Section: Methodsmentioning

confidence: 99%

Mobile PCR-based surveillance for SARS-CoV-2 to reduce visiting restrictions in nursing homes during the COVID-19 pandemic: a pilot study

et al. 2021

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Purpose Residents in nursing homes for the elderly (NH) are at high risk for death from COVID-19. We investigated whether repeated non-mandatory RT-PCR SARS-CoV-2 surveillance of NH staff and visitors reduces COVID-19 incidence rates in NH residents and allows to reduce visiting restrictions. Methods This pilot study at the beginning of the COVID-19 pandemic compared a surveillance approach of regular, twice-weekly voluntary PCR testing of health-care workers (HCW) and visitors in interventional NH (INH) with a setting without regular testing in control NH (CNH). Residents were not tested routinely within this study. Testing was performed in a mobile testing site with same-day result reporting. SARS-CoV-2 incidence among residents in both INH and CNH was the primary endpoint; secondary endpoints being SARS-CoV-2 infection among visitors and HCW in INH. Results Two INH and two CNH participated between October and December, 2020. At INH1, 787 tests of HCW and 350 tests of visitors were performed, accounting for 18.1% (n = 1930) of visits. At INH2, 78 tests of HCW and 372 tests of visitors were done, i.e., 30.5% (n = 1220) of visits. At the two INH 23 HCW and three visitors tested positive for SARS-CoV-2. COVID-19 outbreaks occurred among residents in INH1 (identified through study testing) and in CNH1. Utilization of voluntary testing was low. Conclusion In a real-world setting without available rapid testing, voluntary RT-PCR SARS-CoV-2 testing of HCW and visitors does not prevent COVID-19 outbreaks in NH. Complete, non-selective testing for these groups should be instituted before visiting restrictions can be reduced. Trial registration The study has been registered at ClinicalTrials.gov with the identifier: NCT04933981.

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Section: Methodsmentioning

confidence: 99%

Mobile PCR-based surveillance for SARS-CoV-2 to reduce visiting restrictions in nursing homes during the COVID-19 pandemic: a pilot study

et al. 2021

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“…They have also been demonstrated to be useful in the triage of COVID-19 patients, as they have reduced the number of unnecessary consultations, hence reducing the exposure of the staff to COVID-19 [ 6 ]. Web-based COVID-19 symptom checkers and triage tools have also proved useful in scheduling tests [ 7 , 8 ], monitoring symptoms [ 9 - 11 ], providing evidence-based educational value [ 8 , 9 , 12 ], and supporting self-isolation [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Application of a Web-based Self-assessment Triage Tool During the COVID-19 Pandemic: Descriptive Study

Nowicka¹,

Jaszczak²,

Szymanek-Pasternak³

et al. 2022

JMIR Hum Factors

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Background The COVID-19 pandemic has sped up the implementation of telehealth solutions in medicine. A few symptom checkers dedicated for COVID-19 have been described, but it remains unclear whether and how they can affect patients and health systems. Objective This paper demonstrates our experiences with the COVID-19 risk assessment (CRA) tool. We tried to determine who the user of the web-based COVID-19 triage app is and compare this group with patients in the infectious diseases ward’s admission room to evaluate who could benefit from implementing the COVID-19 online symptom checker as a remote triage solution. Methods We analyzed the answers of 248,862 people interacting with an online World Health Organization–based triage tool for assessing the probability of SARS-CoV-2 infection. These users filled in an online questionnaire between April 7 and August 6, 2020. Based on the presented symptoms, risk factors, and demographics, the tool assessed whether the user’s answers were suggestive of COVID-19 and recommended appropriate action. Subsequently, we compared the sociodemographic and clinical characteristics of tool users with patients admitted to the Infectious Diseases Admission Room of J. Gromkowski Hospital in Wrocław. Results The CRA tool tended to be used by asymptomatic or oligosymptomatic individuals (171,226 [68.80%] of all users). Most users were young (162,432 [65.27%] were below 40 years of age) and without comorbidities. Only 77,645 (31.20%) of the self-assessment app users were suspected of COVID-19 based on their reported symptoms. On the contrary, most admission room patients were symptomatic—symptoms such as fever, cough, and dyspnea were prevalent in both COVID-19-positive and COVID-19-negative patients. COVID-19-suspected patients in the CRA tool group presented similar COVID-19 symptoms as those who presented to the admission room. These were cough (25,062/40,007 [62.64%] in the CRA tool group vs 138/232 [59.48%] in the admission room group), fever (23,123/40,007 [57.80%] in the CRA tool group vs 146/232 [62.93%] in the admission room group), and shortness of breath (15,157/40,007 [37.89%] in the CRA tool group vs 87/232 [37.50%] in the admission room group). Conclusions The comparison between the symptomatology of the users interacting with the CRA tool and those visiting the admission room revealed 2 major patient groups who could have benefited from the implementation of the self-assessment app in preclinical triage settings. The primary users of the CRA tool were young, oligosymptomatic individuals looking for screening for COVID-19 and reassurance early in the COVID-19 pandemic. The other group were users presenting the typical symptoms suggestive of COVID-19 at that time. The CRA tool recognized these individuals as potentially COVID-19 positive and directed them to the proper level of care. These use cases fulfil the idea of preclinical triage; however...

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“…They have also been demonstrated to be useful in the triage of COVID-19 patients, as they have reduced the number of unnecessary consultations, hence reducing the exposure of the staff to COVID-19 [6]. Web-based COVID-19 symptom checkers and triage tools have also proved useful in scheduling tests [7,8], monitoring symptoms [9][10][11], providing evidence-based educational value [8,9,12], and supporting self-isolation [13].…”

Section: Introductionmentioning

confidence: 99%

Application of a Web-based Self-assessment Triage Tool During the COVID-19 Pandemic: Descriptive Study (Preprint)

Nowicka¹,

Jaszczak²,

Szymanek-Pasternak³

et al. 2021

Preprint

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BACKGROUND (-) OBJECTIVE COVID-19 pandemic has sped up the implementation of telehealth solutions in medicine. This paper demonstrates our experiences with the COVID-19 Risk Assessment Tool. We tried to determine who is the user of the web-based COVID-19 triage application and compare this group with the patients of the infectious diseases ward’s admission room to evaluate who could benefit from implementing the COVID-19 online symptom checker as a remote triage solution. METHODS We have analyzed the answers of more than 650 000 people interacting with an online WHO-based triage tool for assessing the probability of SARS-CoV-2 infection. Based on the presented symptoms, risk factors, and demographics, the tool has assessed if the user’s answers are suggestive of COVID-19 and recommended appropriate action. Subsequently, we have compared “patient profiles” of tool users with patients admitting to the Infectious Diseases Admission Room. RESULTS COVID-19 Risk Assessment tool tended to be used by asymptomatic or oligosymptomatic individuals, which constituted 70.58% of all users. The majority of users were young (67.30% were below 40 years of age) and without significant comorbidities. On the contrary, most admission room patients were symptomatic - symptoms like fever, cough and dyspnea were prevalent in both covid positive and negative patients. COVID-suspected patients in the self-assessment tool presented similar COVID-19 symptoms as those who presented to the admission room. These were: cough (66.51% in self-assessment tool, 59.48% in the admission room, P=.03), fever (57.79% in the self-assessment tool, 62,93% in the admission room, P=.13), and shortness of breath (8.73% in the self-assessment tool vs. 37.50% in the admission room, P<.001). CONCLUSIONS The self-assessment COVID-19 tool, as it served as the means of screening and self-education, did not substitute for the consultation in the admission room for symptomatic patients. It seems that these types of solutions may serve as health information hubs for oligosymptomatic individuals, as well as a way of identifying and advising patients at risk. It fulfils the idea of remote, pre-clinical triage, however, the accuracy and influence on healthcare must be examined in the clinical setting.

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Web-based, rapid and contactless management of ambulatory patients for SARS-CoV-2-testing

Cited by 4 publications

References 21 publications

Mobile PCR-based surveillance for SARS-CoV-2 to reduce visiting restrictions in nursing homes during the COVID-19 pandemic: a pilot study

Mobile PCR-based surveillance for SARS-CoV-2 to reduce visiting restrictions in nursing homes during the COVID-19 pandemic: a pilot study

Application of a Web-based Self-assessment Triage Tool During the COVID-19 Pandemic: Descriptive Study

Application of a Web-based Self-assessment Triage Tool During the COVID-19 Pandemic: Descriptive Study (Preprint)

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