RT Journal Article
SR Electronic
T1 Developing a pulse oximetry home monitoring protocol for patients suspected with COVID-19 after emergency department discharge
JF BMJ Health & Care Informatics
JO BMJ Health Care Inform
FD BMJ Publishing Group Ltd
SP e100330
DO 10.1136/bmjhci-2021-100330
VO 28
IS 1
A1 David B Gootenberg
A1 Nicholas Kurtzman
A1 Thomas O’Mara
A1 Jennifer Y Ge
A1 David Chiu
A1 Nathan I Shapiro
A1 Oren J Mechanic
A1 Alon Dagan
YR 2021
UL http://informatics.bmj.com/content/28/1/e100330.abstract
AB Objectives Patients with COVID-19 can present to the emergency department (ED) without immediate indication for admission, but with concern for decompensation. Clinical experience has demonstrated that critical illness may present later in the disease course and hypoxia is often the first indication of disease progression. The objectives of this study are to (a) assess feasibility and describe a protocol for ED-based outpatient pulse-oximetry monitoring with structured follow-up and (b) determine rates of ED return, hospitalisation and hypoxia among participants.Methods Prospective observational study of patients presenting to a single academic ED in Boston with suspected COVID-19. Eligible patients were adults being discharged from the ED with presumed COVID-19. Exclusion criteria included resting oxygen saturation <92%, ambulatory oxygen saturation <90%, heart rate >110 beats per minute or inability to use the device. Study personnel made scripted phone calls on postdischarge days 1, 3 and 7 to review the pulse-oximetry readings and to evaluate for decompensation. Return visit and admission information were collected via medical record and 28-day follow-up calls.Results 81 patients were enrolled of which 10 (12%) developed hypoxia after their initial discharge from the ED. Overall, 23 (28%) of the 81 patients returned to the ED at least once and 10 of those who returned (43%) were admitted. We successfully contacted 76/81 (94%) of subjects via phone at least once for follow-up assessment.Discussion Patients are eager and willing to participate in home monitoring systems and are comfortable with using technology, which will allow providers and health systems to extend our hospitals capabilities for tracking patient populations in times of crisis.Conclusions It is feasible to implement an outpatient pulse-oximetry monitoring protocol to monitor patients discharged from the ED with confirmed or suspected COVID-19.All data relevant to the study are included in the article or uploaded as supplementary information. Please contact the corresponding author for access to any additional data you may deem relevant that was not included.