One initiative that shows promising potential to increase efficiency in treating COVID-19 patients is remote monitoring (RM). patientMpower is an Irish digital health firm that has developed a remote monitoring solution for COVID-19 on behalf of the Health Service Executive (HSE). This enables home monitoring of otherwise healthy patients with mild to moderate symptoms who are in self-isolation, either having tested positive and/or are symptomatic. In this project, we propose to explore the acceptability and utilisation of the device as well as the RM programme’s potential to deliver appropriate care and reduce the COVID-19 burden on hospitals and GP practices. The project will focus on 2 sites: 1) The Mater Hospital COVID-19 Virtual Clinic (MMUH CVC) monitoring patients who are using the app at homes; 2) Community Health Organisation 3 in the Mid-West where three COVID-19 Community Assessment Hubs – based in Clare, Limerick and Tipperary – are being established. The aim of the hubs is to prevent patients from overburdening the hospital system. This mixed-methods study will adopt an iterative approach, engaging stakeholders to ensure the optimum study design, efficient data capture, informed analysis and interpretation of findings as they emerge, and timely and continuous dissemination, to inform the development of an expanded programme of RM.
The benefits of this approach include the patient being able to continue self-isolation, reducing infection risks associated with in-person GP attendances, reduction in unnecessary hospital bed occupancy and reassurance for the patient and the GP
The aim of this project is to assess the potential for RM and rapid assessment through Community Assessment Hubs (CAHs) to reduce the COVID-19 burden on hospitals and GP practices. The specific objectives are to:
- Examine the impact of this innovative RM programme and CAHs on patient outcomes.
- Assess the programme’s impact on patient throughput, prevented admissions and resource utilisation.
- Determine the acceptability, preferences, and adherence to RM for COVID-19 patients and develop strategies to improve adherence (for MMUH patients only).
- Identify whether the programme is more effective for specific patient cohorts, in order to inform clinical decision making.
- Track ED attendances and hospital admissions to UHL and identify any changes in the severity of cases pre and post the introduction of the CAHs.
- Track rate of discharge from the MMUH CVC clinic, as well as deterioration leading to readmission or death.
- Determine the acceptability and challenges of RM and CAHs for clinical staff and the particular aspects of the current programme that could be improved or adapted for COVID-19 monitoring post discharge, for expansion to monitoring symptomatic patients waiting on test/test results and for other patient cohorts that might be suitable for remote monitoring e.g. COPD patients, patients discharged from ED without diagnosis with mild to moderate symptoms, other GP patient cohorts.
The project will be executed in two sites: 1) CVC Clinic MMUH; 2) CAHs in CHO3 area. As the research team is relatively large with clinicians who are frontline staff for COVID-19 patients, time efficiency in the management and execution of the project is paramount. Rapid knowledge dissemination and sharing is required. We will, therefore, execute the project in both sites in parallel, with the research team serving as the knowledge bridge and holding joint 30-minute zoom meetings and webinars across the sites to facilitate rapid knowledge transfer.
The project team is led by Professor Eilish McAuliffe, Professor of Health Systems and Dr Aoife DeBrun, Assistant Professor and AD Astra Fellow at UCD, Professor Liam Glynn, Professor of General Practice at University of Limerick and Dr Tara McGinty, Consultant in Inclusion Health and Infectious Diseases at Mater Misericordiae University Hospital and Associate Professor at UCD .The team consists of clinical, administrative and academic staff across the 2 sites and UCD and UL. The research staff includes 2 postdoctoral researchers, a research assistant (based in UCD), a part-time clinician scientist (based in UL), and a part-time project manager.