The Covid-19 pandemic has led to an acceleration in digital health innovation and healthcare providers have been quick to implement alternative solutions to in-person care to ensure patients can continue to access diagnostic and therapeutic services. This has led to increased use of remote patient monitoring (RPM), telemedicine platforms and virtual clinical trials.
Trends in digital health adoption are likely to continue after the pandemic has abated. Remote delivery of care and virtual platforms will alleviate pressures on health systems and provide novel and convenient avenues of care delivery, particularly for those living in rural areas. For instance, the UK’s National Health Service (NHS) updated its clinical guide to encourage remote contact through telephone, email and video conferencing. This has resulted in increasing demand for diabetic care devices that can share data remotely. There is significantly more data available using continuous glucose monitoring (CGM) devices, which can help patients and healthcare providers improve glycemic control and potentially increase patient self-management.
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Tools such as RPM have been increasingly used on Covid-19 patients. In particular, RPM models using pulse oximetry and other vital sign measurements such as temperature that seek to monitor patients remotely have been implemented for suspected Covid-19 cases across numerous countries. Home pulse oximeters have long been used in primary care settings, usually monitoring chronic lung disease and heart failure. However, because of the pandemic, many people have purchased their own pulse oximeter for self-monitoring.
A new way to deploy pulse oximeters to monitor discharged Covid-19 patients was reported by Dr Christine Patte and colleagues in the Academic Emergency Medicine Journal (2020). Patte, from the Swedish Hospital Emergency Medicine Residency Program, described new guidelines for the appropriate home care for patients suffering from Covid-19 and public management of any close contacts. They developed a novel use for home pulse oximetry monitoring in Covid‐19 patients discharged from the emergency department and for monitoring patients staying at home. The protocols allow for safe monitoring for silent hypoxia in patients affected by Covid-19, enabling timely intervention and thus reducing hospital re-admission rates. The study protocol describes the discharge of non-severe Covid-19 patients from hospitals and subsequent recovery at home using portable pulse oximetry devices that report a patient’s oxygen saturation levels. This helps to identify if an individual needs to be hospitalised based on the pulse oximeter readings. As a result, patients can safely and comfortably recover at home, enabling healthcare facilities to manage resources and reduce overcapacity issues.
As health expenditure increases and patients become more engaged and involved, virtual health interventions will play an important role in meeting demand. This will require a significant overhaul to ensure that integrated community and home-based medical care is available to all, with a future healthcare model focused on prevention, wellbeing and early intervention.
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