Fighting COVID remotely

Kevin Robinson-Avila, Albuquerque Journal, N.M.
·5 min read

Mar. 1—ALBUQUERQUE, N.M. — Patients enrolled in the COVID-19-to-Home program receive a console and a finger-touch emergency wrist band to immediately connect with medical professionals.When last fall's nationwide upsurge in COVID-19 threatened to overwhelm hospitals in New Mexico and elsewhere, Doña Ana County organizations came together to fight the spike with remote-monitoring technology.

Local public and private entities rapidly assembled a novel "COVID-to-Home" program that combined cutting-edge telemedicine with broad community coordination to closely monitor patients at home or in hotel rooms, allowing area hospitals to reserve beds for the most critical COVID-19 patients.

Public officials and medical providers say the program staved off potential overload at two Las Cruces-based facilities, Memorial Medical Center and MountainView Regional Medical Center.

"The hospitals here were facing a critical moment as the number of COVID patients rapidly climbed to peak levels," said county Health and Human Services Director Jamie Michael. "But they never reached capacity because the program kept people at home in a safe environment, with physicians remotely monitoring them."

The program, which launched in late November and continues today, has freed up about 250 hospital beds for the most at-risk patients, said Dr. Danielle Pattison, a physician with Memorial Medical Center's family residency program.

"During the peak of the crisis, we were able to take care of patients with some oxygen requirements who would usually be treated in the hospital," Pattison said. "We monitored them at home, checking in with those patients daily, or more often, depending on how sick they were. That freed up beds for patients who really needed it while taking care of other people in a safe manner at home."

The Las Cruces-based telemedicine company Electronic Caregiver helped set up the program, supplying all the monitoring technology and coordinating electronic connections around the clock between patients and medical providers.

But it's Doña Ana County's broad community collaboration that paved the way for program success, said Tim Washburn, Electronic Caregiver's chief clinical officer. Apart from the medical centers, New Mexico State University's nursing program, the Burrell College of Osteopathic Medicine and New Mexico Department of Health's Medical Reserve Corps have all assisted in care coordination.

The county and the City of Las Cruces each contributed $50,000 to pay for the program, allowing patients to receive services for free.

"The community really came together because, if we ran out of hospital beds, we'd all be impacted," Washburn said. "The program shows that combining tele-monitoring with effective care coordination creates an amazing difference in the overall management of illness."

Cost savings

Apart from freeing up hospital beds, the program has saved patients and providers a lot of money, said Mark Francis, chief digital health integration officer at Electronic Caregiver.

The national Health Affairs Journal estimates that 10 days of in-hospital COVID-19 care costs an average of about $14,300 per patient. In contrast, remote monitoring through the COVID-to-Home program costs $300 per patient for 30 days of care.

As of mid-February, 247 COVID-19 patients had participated in the program, costing about $74,000. That compares to about $3.5 million had all those patients received in-hospital treatment.

"The program frees up hospital beds at 1/50th the cost of in-hospital care," Francis said. "It's tremendous savings and, under the COVID-to-Home program, there's no cost for patients to participate and no proof of insurance is required. That breaks down real or perceived barriers to health care accessibility and helps to mitigate uncontrolled community spread of the virus."

High-tech tracking

Under the program, Electronic Caregiver provides each patient with a "Pro Health" package of remote monitoring devices that track vitals while maintaining a constant connection with medical professionals. That includes a pulse oximeter to measure oxygen levels, a non-contact thermometer and a blood pressure cuff, all of which are electronically connected to a small console that health care staff access remotely through a secure web portal that complies with federal health information privacy regulations.

Patients also receive a watch-like wrist band with an emergency button to immediately connect with a nurse or clinical staff. The voice-driven console acts like a mobile phone, avoiding broadband or online connectivity issues.

"We program everything before the patient goes home," Francis said. "They just plug in the console and it all works through cellular technology."

$55M investment

Electronic Caregiver has invested about $55 million to develop a broad base of remote-monitoring technology for health care providers since launching in 2009. Demand for its services has spiked during the pandemic, demonstrating the advantages of telemedicine in managing the COVID-19 crisis and health care services in general.

Without COVID-to-Home, many participating patients might not have received any medical care, said Dr. John Andazola, who heads Memorial Medical's family residency program.

"I think building a structure where we can treat people at home so the higher-resource needs are available to those who need it is really what this program has demonstrated," Andazola said in a statement.

Intel Corp. awarded a $150,000 grant in late December for Electronic Caregiver to further develop and potentially deploy the COVID-to-Home program in more communities. The grant comes from Intel's $50 million Pandemic Response Technology Initiative, which the company launched at the start of the pandemic to support and accelerate new point-of-care solutions for patients.

Patient feedback

Program participants say COVID-to-Home met all their needs.

Las Cruces resident Joyce Jones, 58, said doctors told her she nearly died from the virus during a two-week stay in the hospital in December. The hospital discharged her on Dec. 15, but she was still having trouble breathing, so medical staff enrolled her in the remote-monitoring program, and sent her home with oxygen tanks and an electronic albuterol inhaler.

Apart from the emergency wristband to connect with health care professionals, she also received a necklace with the same push-button connection capability as a backup emergency device in case she fell. And she spoke daily with doctors.

"That's what I liked most — being in close contact with doctors," Jones said. "They made lots of suggestions, like how to help with my breathing, but just having a medical professional on the phone listening to me every day was wonderful. It gave me real peace of mind."