COVID-19 vaccines are a welcome sight as people across the country are flocking to get their shots.
Nevertheless, not everyone can take that giant leap forward quite yet, as individuals and families still are struggling with the virus, which has caused a strain on health care systems throughout the region.
To ease one of its burdens, Metro Health–University of Michigan Health is reducing COVID-19 patients’ hospital stays through its new 24/7 home-monitoring program.
Dr. Lance Owens, chief medical information officer for Metro Health–University of Michigan Health, said 70 patients have been discharged from the program since it began in mid-November when Michigan was experiencing its second surge and there are currently four patients enrolled in the program. As a result, Owens said Metro has eliminated approximately 730 in-patient days.
“During the second surge, the death rate was going down although the hospitalization rate was going up,” Owens said. “The hospitalization length of stay was going up. The system was being overtaxed. The hospitals were full, the ICUs were full and that was everyone here in town. We were struggling to the point where we were having serious issues with staffing and deciding where patients were going to go. All of the hospitals in town were discussing large-scale convalescent units, setting up field hospitals in the DeVos Place, warehouses and things like that. There were challenges in different ways and that was when we came up with the idea of getting a certain number of patients out of the hospital to free up beds in the hospital. Not only were the beds full of COVID patients, but we couldn’t do things like elective surgeries because we couldn’t admit the patients in the hospital and watch them afterward. It kind of paralyzed the entire system. We did have to ration care there a little bit.”
The program allows COVID-19 patients who are cleared by the Metro Health Advance Practice Provider (APP) team, which is made up of nurse practitioners and physician assistants, to begin home recovery with frequent virtual check-ins with the medical staff at the hospital.
Owens said before COVID-19 patients can enroll in the program they have to be off steroids and antibiotics, have their oxygen levels checked and have proper support at home.
Once they’re deemed ready, Metro Health, in partnership with Health Recovery Solutions, equips patients with an internet-connected tablet and Bluetooth-synched peripherals: a thermometer, a blood pressure cuff, a pulse oximeter and a scale to take home. The technology is provided by Health Recovery Solutions, which provides telehealth and remote patient-monitoring solutions.
“Everything is run through the tablet,” Owens said. “On the tablet is their information, their medications, reminders to take their medications and there are a few surveys. We ask the patients to take daily surveys based on how they are feeling, and it puts them in a certain zone based on their symptoms. We ask them to take their daily weight, their blood pressure twice per day and their pulse ox at least once a day. All that information is Bluetooth-connected to the tablet so when the patient takes all these vitals it gets recorded into the tablet, which almost immediately gets sent to our portal. We have a remote monitoring system that we use to watch the patient and we can see what vitals they’ve entered.
Metro Health patients use the equipment for an average of 10 days. Once they’ve recovered and are done using the equipment, FedEx picks it up and sends it to a processing center where it gets sanitized and repackaged for use again.
“What we are noticing is that patients love this program,” Owens said. “If you have COVID under current guidelines and you are in a hospital room, you are usually by yourself because you can’t have visitors because you have COVID, you can’t clean your room because you have COVID, you are basically left to your own devices and whatever entertainment you have, i.e., your TV or iPad, and that is it. That is all you have.
“People can bring you food, but it is almost like a prison cell,” he said. “The nurses and physicians obviously take care of you, but you can’t have family around so the COVID recovery plan allows those patients to go home. They can sleep in their own bed, they can drink their own water, they can eat their own food, they can have family around appropriately with social distancing, masking and things like that.”
Owens said studies have shown patients in general are apt to recover better in a home environment.
“Study after study shows that when patients are able to convalesce in an area that they feel more comfortable in, i.e., their home, they get better faster, and we’ve noticed that.”