Background
Remote patient monitoring (RPM) has been offered at MedStar Health for years to help patients proactively track their health status—and easily connect with their care team about related questions and updates—using telehealth tools surrounding their visits. RPM connects patients with providers through an online platform, available via a mobile app, that allows providers to monitor patient health vitals, symptoms, and more outside of traditional healthcare facilities (e.g., a patient’s home). Patients enter their own health information, using tools like pulse oximeters, and are connected with their provider via a messaging service to answer any questions about changes in their condition.
The MedStar Health RPM program supports patients with managing high acuity needs (e.g., palliative care), chronic conditions (e.g., hypertension), and specialized needs (e.g., maternal-fetal medicine). RPM has also been integrated into gerontological care in the MedStar Health system and beyond, allowing older adults to delay moving to assisted care facilities and instead receive care at home.
When the pandemic struck, MedStar Health quickly recognized an opportunity to expand its RPM program to include select high-risk COVID-19 patients.
Idea
At the start of the COVID-19 pandemic, MedStar Health rapidly expanded and scaled its telehealth offerings to address the historic demand for connected care options.
RPM was identified as a care option for select COVID-19 patients who were discharged from MedStar Health Emergency Departments, monoclonal antibody infusion sites, and certain inpatient settings to support their treatment and recovery outside a traditional health facility. With particular focus on immunocompromised patients or those with comorbidities, the program enabled providers to remotely monitor these patients with higher-risk cases for up to 16 days. By allowing some high-risk patients to recover and be remotely monitored from home, facilities could be reserved for more urgent medical needs; personal protective equipment (PPE) could be saved given the remote setting for patients and some providers; and RPM could serve as yet another telehealth tool for reducing community spread.
To help qualifying patients easily enroll in the COVID-19 RPM program, MedStar Health staff created an equipment kit to assist patients in signing up for the program. It included a QR code for patients to download the mobile app, as well as a pulse oximeter to obtain their oxygen saturation and heart rate information via Bluetooth connection. As they used the application, patients would also manually take and enter their own temperature and answer a series of questions about how they were feeling. The app set up a two-way communications channel with a provider who would check on patient vitals and symptoms—optimally at least once daily—and address any patient questions or concerns.
Impact
Since the start of the COVID-19 pandemic, there have been more than 10,600 patient enrollments in the COVID-19 RPM program. Most of the patients actively participating in the program have been able to safely recover in their own homes.
The program was also successful in proactively identifying patients with worsening systems or unrelated medical challenges to be readmitted to a MedStar Health facility or receive elevated medical care as needed. As one example, the COVID-19 RPM program helped quickly identify a COVID-19 patient with worsening chest pain, shortness of breath, and other concerning symptoms who needed immediate care. The team contacted the patient and initiated a video call, then called 911 when the condition worsened. The patient’s care team stayed on video until emergency medical services arrived and could take the individual to a MedStar Health hospital. The patient was ultimately able to make a swift recovery thanks to the proactive monitoring and care provided.
As of spring 2022, the number of COVID-19 community cases had decreased and demand for the COVID-19 RPM program had similarly declined, so MedStar Health decided to sunset the COVID-19 RPM program. However, the program is flexible and can be rapidly resumed if patient demand again increases. The team continues to share information about the program within the healthcare community through conferences, research, and other outreach (see resources below). MedStar Health also continues to offer and explore other RPM programs. Most recently, additional patients have been enrolled in hypertension programs, allowing care teams to remotely monitor blood pressure and engage with patients for improved chronic disease management and quality.
RPM is just one tool in the larger telehealth landscape at MedStar Health. In the first two years of the COVID-19 pandemic response, we have supported an estimated 1.5 million telehealth encounters, including remote patient monitoring, video visits, audio-only care, facility-based teleconsultations, and more. Patients have shared that the availability of care via telehealth tools has helped them recover—and do so with more peace of mind.
Resources
Program Video
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MedStar Health YouTube, “MedStar Health treats COVID-19 and transplant patient at home via Remote Patient Monitoring” (June 2, 2022)
News
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NBC Washington News 4, “MedStar Health to Expand Use of Tech That Monitors Patients From Their Homes” (May 4, 2022)
Event
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ATA 2022 Annual Conference and Expo, “Ensuring Equity: Lessons from COVID-19 Remote Patient Monitoring” (May 3, 2022)
Award
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AAEM 2022 Scientific Assembly, Young Physician Section Research Competition 1st place, “Large-Scale Implementation of a COVID-19 Remote Patient Monitoring Program” (April 26, 2022)
Websites
Provider Perspective
“At MedStar Harbor Hospital, we all really appreciated having remote patient monitoring (RPM) as an option for establishing a safe discharge for higher risk patients. It was great knowing that our team could still regularly check on our patients and get them care if and when they needed it.
I presented the RPM program at our Hospital Leadership meetings several times, both to share this exceptional work and safety moments, noting several patients who returned to the emergency department and were admitted based on recommendations by RPM clinicians.
Word quickly spread of the RPM program and our hospitalist colleagues and case management social workers frequently asked if we could enroll patients after hospital discharge. This really highlights the quality and care this program provided.
Overall, RPM is a great example of the innovation and resourcefulness that really defines MedStar Emergency Physicians (MEP) and MedStar Health."
- Christopher Wilbert, MD, Chair of Emergency Medicine at MedStar Harbor Hospital
Patient Testimonial
Note: Patient testimonial has been lightly edited for clarity and length.
“I had COVID-19 and I was pretty sick…. I was scared, so I contacted MedStar Health and immediately I was admitted. They went through all my symptoms and they determined that because my case wasn’t as severe as others, they sent me home with the at-home monitoring system. It was very easy, very convenient—took me a few seconds to download the app. The pulse ox monitor was very simple. Put it on the tip of your finger and push one button and it was done. The results are immediately transmitted to their system where their nurse practitioners can take a look and determine if you need further care. They monitored my condition daily and they were still looking after me, but remotely.”
“For roughly three weeks, they monitored my condition. And it worked really well for me… It’s amazing—you receive the care that you need, even if you’re at home. It's definitely a way for you to have peace of mind when you're not right there in the hospital.”
- MedStar Health patient (Watch the related MedStar Health YouTube video)
Page first published: 7/12/22
Summary
This program offered enrolled COVID-19 patients a remote care option through connected devices, an easy-to-use mobile platform, and the support of a clinical team following a visit to a MedStar Health Emergency Department or monoclonal infusion center.
Team
MedStar Telehealth Innovation Center (MTIC), MedStar Medical Group (MMG), MedStar Emergency Physicians, and others
Status
Concluded
