全球突发事件患者远程监测:COVID-19患者案例研究

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES
Ramin Ramezani, Wenhao Zhang, Minh Cao, Alex Bui, Antonia Petruse, Amelia Weldon, Arash Naeim
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引用次数: 0

摘要

背景:2019冠状病毒病大流行凸显了在卫生保健服务中对远程医疗和患者远程监测的迫切需求。尽管越来越多的人使用穿戴式传感器来持续监测和预测不良事件,但它们的广泛采用仍然是一个重大挑战。虽然大流行病加速了对这些技术的接受,但要实现广泛整合,就需要将这些技术持续纳入紧急情况以外的常规卫生保健做法。在本研究中,我们将之前开发的远程患者监测系统的应用扩展到COVID-19患者。目的:我们的目标是评估从我们之前开发的系统中获得的指标是否可以为受COVID-19影响的个体的恢复轨迹提供额外的见解。本案例研究旨在证明,在紧急情况下,远程患者监测系统可以适应不同的患者群体。我们的目标是说明部署的便利性,特别是当这些系统已经集成到现有的医疗保健生态系统中时。方法:从2020年11月至2021年7月,在同意参加本研究2周后,通过加州大学洛杉矶分校智能健康中心招募了73名患者。本研究侧重于探索性分析,重点对患者远程监测系统捕获的COVID-19患者的特征和行为进行详细检查。我们收集了以下传感器测量值的日常变化:日常活动、每日能量消耗、室内定位、SpO2、呼吸速率、心率和温度。结果:在符合纳入标准的73例患者中,41例成功坚持使用监测技术,仅有22例提供了大量的观察数据(>4 h)。在参与者中,39人使用脉搏血氧仪,37人使用体温计,36人在夜间使用呼吸监测。这项研究表明,在研究结束时,患者的活动水平总体上有所增加,许多患者在两周后开始离开家。此外,呼吸频率转向更健康的低水平,血氧饱和度也有所改善。疲劳和头痛被认为是最普遍的症状,其次是咳嗽和嗅觉丧失。结论:该结论强调了在医院外监测患者的关键重要性,特别是在大流行期间,当患者前往医院或接受卫生保健专业人员的家访时,这可能增加疾病传播的风险。研究表明,在家庭环境中进行远程监测的好处和功效可以使卫生保健专业人员更好地为未来的大流行事件做好准备。持续监测从活动到生命体征的各种患者指标,并将这些数据集成到电子健康记录中,不仅可以提高准确性,减轻数据收集的负担,还可以为增强家庭护理铺平道路,以更低的成本提供更高质量的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Remote Patient Monitoring for Global Emergencies: Case Study in Patients With COVID-19.

Background: The COVID-19 pandemic has highlighted the critical need for telehealth and remote patient monitoring in health care delivery. Despite the growing use of on-body wearable sensors for continuous monitoring and predicting adverse events, their widespread adoption remains a significant challenge. While the pandemic has accelerated the acceptance of these technologies, achieving widespread integration requires their sustained incorporation into routine health care practices beyond emergencies. In this study, we extend the application of our previously developed remote patient monitoring system to patients with COVID-19.

Objective: Our objective is to assess whether the metrics obtained from our previously developed system can provide additional insights into the recovery trajectory of individuals affected by COVID-19. This case study aims to demonstrate that remote patient monitoring systems can be adapted to diverse patient cohorts during emergencies. We aim to illustrate the ease of deployment, particularly when these systems are already integrated into the existing health care ecosystem.

Methods: From November 2020 to July 2021, a total of 73 patients were recruited through the University of California, Los Angeles, Center for Smart Health, after having consented to participate in this study for 2 weeks. The research concentrated on an exploratory analysis, focusing on the detailed examination of characteristics and behaviors of patients with COVID-19 as captured by the remote patient monitoring system. We collected day-to-day changes in the following sensor measurements: daily activity, daily energy expenditure, indoor localization, SpO2, respiratory rate, heart rate, and temperature.

Results: Out of the 73 patients satisfying the inclusion criteria, 41 successfully adhered to using the monitoring technology, with only 22 providing substantial watch data (>4 h). Among the participants, 39 used the pulse oximeter, 37 used the thermometer, and 36 used respiratory monitoring at night. This study demonstrated an overall increase in patients' activity levels toward the end of this study, with many beginning to leave their homes after 2 weeks. Additionally, respiratory rates shifted toward healthier lower levels, and oxygen saturation improved. Fatigue and headache were identified as the most prevalent symptoms, followed by cough and loss of smell.

Conclusions: The conclusion highlights the critical importance of monitoring patients outside of hospital settings, especially during pandemics, when patients travel to hospitals or receive home visits by health care professionals, which could increase the risk of disease transmission. Studies demonstrating the benefits and efficacy of remote monitoring in home settings can better prepare health care professionals for future pandemic events. Continuous monitoring of a wide range of patient metrics, from activities to vital signs, and integration of these data into electronic health records would not only improve accuracy and reduce the burden of data collection but also pave the way for enhanced home care, offering higher quality care at a lower cost.

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来源期刊
JMIR Formative Research
JMIR Formative Research Medicine-Medicine (miscellaneous)
CiteScore
2.70
自引率
9.10%
发文量
579
审稿时长
12 weeks
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