Acute remote home monitoring of acutely ill patients with COVID-19: how Dutch home monitoring initiatives were organized during the pandemic

Abstract

BACKGROUND: Acute remote home monitoring of acutely ill patients with COVID-19 holds potential for early detection of deterioration and thus subsequentearly intervention that may prevent or mitigate progression to severe illness and need for respiratory support. Our aim was to describe common features of acute remote home monitoring programs for acutely ill patients with COVID-19 in the Netherlands. METHODS: We performed literature searches (both grey and academic) between 1st March 2020 and 1st March 2023 to identify Dutch acute remote home monitoring initiatives, excluding studies on early hospital discharge. From the available protocols, we extracted relevant information on patient eligibility, organization of acute remote home monitoring and home management. RESULTS: We identified and approached ten acute remote home monitoring initiatives for information regarding their used protocols. Seven out of ten protocols were retrieved and assessed. All initiatives focused on adult patients with COVID-19 who where at risk of developing severe COVID-19, and all initiatives provided close follow-up through remote home monitoring using medically certified pulse oximeters. Daily measurements included peripheral oxygen saturation (all initiatives, n = 7), body temperature (n = 6), heart frequency per minute (n = 4) and breathing rate per minute (n = 4). For follow-up and review of measured values, in most initiatives (n = 6) the physician (general practitioner or hospital physician) in charge was supported by a dedicated monitoring center. In 5 out of 7 initiatives, the general practitioner (GP) was responsible for supervising the patients and monitoring staff. CONCLUSION: The acute remote home monitoring initiatives that emerged in the Netherlands during the first wave of the COVID-19 pandemic were similarly organized. Common building blocks for home monitoring include daily check of peripheral oxygen saturation, monitoring through a dedicated remote monitoring center alongside healthcare personnel and a supervising physician.