A look inside Geisinger's new remote monitoring program for COVID-19 patients

Geisinger Health System is harnessing its online patient portal to monitor COVID-19 patients from home.

The goal, leaders at the health system say, is to ensure patients with the virus are tracked effectively while avoiding unnecessary visits to the hospital or primary care doctors' offices. Patients have the option between an app-based system through Epic’s MyChart Care Companion or a telephonic one based on their needs and preferences.

Benjamin Hohmuth, M.D., chief medical informatics officer at Geisinger, said there’s also a significant amount of anxiety for patients who are diagnosed with the virus, and having someone check in regularly can help with that stress.

“Having some point of contact on a daily basis alleviates that,” he told Fierce Healthcare.

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Each patient who tests positive for the novel coronavirus is offered a home care kit that includes masks and other items to help with managing their condition. For those at risk of significant complications, Geisinger’s providers and health plan collaborated to offer a care package that includes a pulse oximeter, digital thermometer and acetaminophen.

A nurse contacts a patient within 24 hours to provide additional details on how to manage the virus and the tools they were given at discharge from either inpatient or outpatient care.  

Patients use the oximeter and thermometer to offer daily updates on their symptoms, said Joann Sciandra, R.N., vice president of care coordination and integration at Geisinger Health Plan. They are also surveyed through the app for other symptoms related to COVID-19.

“We needed to find a way to wrap our arms around patients even closer than just a routine phone call,” Sciandra told Fierce Healthcare.

Acetaminophen was also included specifically because they were hearing COVID-19-positive patients were going out to local pharmacies and stores to buy such drugs to manage their fevers, she said.

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Having those tools at home, Sciandra said, makes patients feel more confident about managing their conditions themselves, again helping to alleviate the anxiety around contracting COVID-19.

Should a patient’s self-reported symptoms worsen, the system will send an automatic alert to a nurse, who will call the patient within 10 minutes to triage their symptoms, Hohmuth said. That visit can be transitioned quickly into a video visit with a physician if needed. Should the symptoms prove severe enough, the nurse will refer the patient to emergency care.

Sciandra said there have been multiple examples to date of the intervention preventing an unneeded visit to the doctor. In one case, a patient reported shortness of breath, and the oximeter did show oxygen levels were low.

Through telehealth, the Geisinger care team was able to bring oxygen into the patient’s home instead of having the patient go to the hospital, she said.

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Patients are prompted to complete the surveys and symptom checks through notifications and badges within the app.

So far, Geisinger has conducted about 15,000 telephone check-ins and 400 to 500 survey entries in the app for its COVID-19 patients, Hohmuth said. He said that while app-based interventions are not necessarily the solution for everyone, the people that take to it truly benefit.

Programs like this, he said, will have legs beyond the pandemic, too.

“Just about everything we’ve done for COVID has given us experience with use cases related to COVID that most of the time I think we’ll be able to adapt to non-COVID use cases,” he said.