An opinion piece written by Chris Paton and Lionel Tarassenko (with two clinical collaborators from Scotland) has been published by the British Medical Journal (BMJ) to advise on implementing and scaling up telemonitoring for COVID-19 patients. Telemonitoring uses information and communication technologies to allow clinicians to safely monitor a patient's health symptoms at home. The authors review some of the challenges and opportunities of remote monitoring, and argue for an evaluative framework that both examines the impacts on clinician workload and patient access, and links data to outcomes to improve predictive tools and health interventions.
They write:
"Thousands of people have been assessed in the community with likely COVID-19. To avoid overwhelming hospitals and to prevent infection of staff and other patients, the majority are sent home with little structured follow-up other than advice to get in contact with healthcare providers if their symptoms worsen. However, some patients are at risk of rapid deterioration, with hospital admission sometimes too late for effective treatment. This has led to calls for more active home monitoring...How telemonitoring should be delivered during COVID-19 will vary according to local care pathways and infrastructure, but all implementations have to address common challenges including usability, choice of data to collect, data transmission, and evaluation and optimisation."
The authors advise that remote monitoring systems need to be simple for clinicians to deploy and explain to patients, and ideally able to work across different types of device, including phones, tablets and computers, so as not to cause access issues for older and poorer people who are more vulnerable.
The authors conclude:
"Routine telemonitoring of those at greater risk of severe disease offers the potential to detect deterioration early, and to provide regular support and advice without compromising quarantine and exposing healthcare workers to unnecessary risk."
The opinon piece is the first publication written by two Reuben College Fellows, and connects their expertise in health informatics and biomedical engineering. It follows shortly after the success of the first grant that was awarded to Prof Tarassenko and Dr Paton for their pilot study to develop a smartphone app to diagnose pneumonia among children in Low and Middle-Income Countries (LMICs).
The other two co-authors of the article are Brian McKinstry and Bruce Guthrie, both from the Usher Institute at the University of Edinburgh.
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