Application of remote videoconferencing to home monitor and support patients with major congenital heart disease during the COVID-19 pandemic

ABSTRACT

Background and Aim: The COVID-19 pandemic presented unique challenges to global healthcare provision. Face-to-face outpatient care was dramatically reduced as a consequence. This study imple-mented a remote videoconferencing call (VC) service delivered by a mobile app to continue close monitoring of our most vulnerable patients in their home environment. The patient cohort was fol-lowed up at a regional paediatric cardiology centre. Method(s) Patient recruitment began in September 2020, concluding in December 2021. Most participants were identified in the new-born/infant period and consisted of a mixture of cyanotic and acya-notic congenital heart disease. All study participants required regular, frequent outpatient monitoring in usual circumstances. Parents/guardians of identified patients received written and verbal explan-ation of study aims and objectives prior to giving written consent. The videoconferencing interface was delivered by PEXIP Infinity Connect Mobile app and conducted by experienced medical and/or nursing staff. This app was already a well established method of communication within the Regional Paediatric Cardiology Team. Primary outcome measures included admissions to hospital and avoidance of hospital attendances. Clinical proformas including growth parameters and clinical observations was recorded at each vir-tual appointment. Patient and parent related research data was col-lected at the first, fourth and eighth appointment. A select number of patients were given home saturation monitors and weight scales. Result(s) A total of 32 patients were enrolled. 164 VCs were deliv-ered (patient mean = 5.8). The average age at recruitment was 10.8 weeks. 18 patients had surgical intervention during the study period. There were 11 admissions to hospital directly resulting from the VC;the commonest indication was abnormal oxygen sat-urations (45%). 33 hospital attendances were avoided;the com-monest concern reported by parents was difficulty related to infant feeding (36%). Conclusion(s) Qualitative and quantitative measurement tools showed reduction in parental anxiety. The study was well received by par-ticipating families. There was prompt identification of unwell chil-dren on VCs as well as providing advice to prevent unnecessary hospital attendance. Videoconferencing technology proved very user friendly and proved to be a very valuable adjunct to the pro-vision of good patient care during challenging circumstances.