Implementation and Impact on Length of Stay of a Post-Discharge Remote Patient Monitoring Program for Acutely Hospitalized COVID-19 Pneumonia Patients

ABSTRACT

Objective In order to manage COVID-19 patient population and bed capacity issues, remote patient monitoring (RPM) is a strategy used to transition patients from inpatients to home. We describe our RPM implementation process for post-acute care COVID-19 pneumonia patients. We also evaluate the impact of RPM on patient outcomes, including hospital length of stay (LOS), post-discharge Emergency Department (ED) visits, and hospital readmission. >Materials and Methods We utilized a cloud-based RPM platform (Vivify Health) and a nurse-monitoring service (Global Medical Response) to enroll COVID-19 patients who required oxygen supplementation after hospital discharge. We evaluated patient participation, biometric alerts, and provider communication. We also assessed the program’s impact by comparing RPM patient outcomes with a retrospective cohort of Control patients who similarly required oxygen supplementation after discharge but were not referred to the RPM program. Statistical analyses were performed to evaluate the two groups’ demographic characteristics, hospital LOS, and readmission rates. Results The RPM program enrolled 75 patients with respondents of a post-participation survey reporting high satisfaction with the program. Compared to the Control group (n = 150), which had similar demographics and baseline characteristics, the RPM group was associated with shorter hospital LOS (median 4.8 vs 6.1 days;P =.03) without adversely impacting return to the ED or readmission. Conclusion We implemented a RPM program for post-acute discharged COVID-19 patients requiring oxygen supplementation. Our RPM program resulted in a shorter hospital LOS without adversely impacting quality outcomes for readmission rates and improved healthcare utilization by reducing the average LOS. LAY SUMMARY To improve hospital operations and bed utilization during the COVID-19 pandemic, we rapidly developed a remote patient monitoring (RPM) program as a strategy to facilitate the discharge of stable COVID-19 patients requiring supplemental oxygen and support their transition from the inpatient setting to home. We share our RPM implementation process and show that enrolled RPM patients were associated with shorter hospital length of stay (LOS) without any adverse impact on quality outcomes, such as return to the Emergency Department or readmission, compared to a cohort of control patients who were not enrolled in RPM. We also show that our RPM program had a high patient engagement rate and positive patient satisfaction. Our results demonstrate that RPM can be an essential part of the healthcare delivery model, as it could positively impact outcomes, healthcare utilization, and patient satisfaction.