IOWA CITY — While the University of Iowa Hospitals and Clinics has ramped up its campus’ preparation for any potential surge in COVID-19 patients requiring hospitalization, most don’t, prompting the facility to roll out a “virtual hospital” as well for the many coronavirus patients recovering at home.
The new initiative provides the about 80 percent of positive COVID-19 patients who don’t need to be hospitalized “direct daily care and support from a team of medical specialists.”
“Being diagnosed with COVID-19 is a pretty scary thing, but being able to navigate it with the help of a doctor or a nurse really gives our patients the support they need,” Bradley Manning, clinical assistant professor of internal medicine and a hospitalist with UI Health Care, said in a statement.
He noted those patients are in self-quarantine, making their recovery particularly isolating and daunting — even if that’s the best place for them to be for their own safety and the safety of the general public and health care professionals. But the providers are still giving support in the form of a “Home Treatment Team” that includes nurses, physicians, pharmacists, and other staff who use telemedicine to monitor and care for the patients as they recover.
“It’s like the doctor is rounding on you while you are in the comfort of your own home,” Manning said.
In addition to the telemedicine check-ins, patients with COVID-19 who are well enough to recover in isolation at home receive a “monitoring kit delivered to their home,” containing a blood pressure cuff and pulse oximeter, which measures a patient’s blood oxygen level and heart rate.
The kit also includes instructions for self-isolation and symptoms they should be watching for. The patients then log their vital signs — including temperature, blood pressure, and oxygen levels — and discusses any issues they’re managing with a health care provider via the daily telephone check-in.
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The system, according to UI Health Care, allows its providers to monitor patient progress in real time “to prevent disease complications” and also gives them the ability to intervene quickly if a patient starts to worsen.
Patient family members also can ask questions or voice concerns.
These daily contacts with COVID-19 patients has afforded UI Health Care workers valuable insights and information about how the disease affects people — including that a large number of those tracked by UICH have experienced an unpleasant taste and fever.
Those, for some patients, are the only symptoms they experience in the early phases of the illness — making it hard for patients to eat enough or drink enough, leading to dehydration. The daily reports of patient blood pressure, heart rate, and urine volume — for example — helps providers track hydration in real time and intervene.
“Based on what we have seen in our patients, staying properly hydrated in the first few days of the illness really seems to be important to a patient’s ability to fight the disease and lower the risk of hospitalization,” Manning said. “The altered sense of taste is a really dramatic symptom and does make it very unpleasant to eat or drink. So, we really emphasize to patients the importance of staying hydrated.”
To date, UIHC — which its administrators have said is one of only a handful of hospitals nationally using this approach to COVID-19 patient care — has served 76 patients through its “virtual hospital.” Of those, 35 have recovered, 38 are still being monitored, and three have been transferred from home to the hospital for more intensive care.
The goal, according to Manning, is to help patients beat the disease without coming to the hospital — keeping more of the hospital’s critical care beds open.
“We are encouraged by our preliminary results, Manning said, recommending other health care systems consider this as a model, “So that we may all better care for our patients and improve outcomes during this pandemic.”
In staying in touch with the area’s COVID-19 patients, UIHC Vice President for Medical Affairs Brooks Jackson earlier this week said his campus is close to receiving approval to begin using plasma from recovered patients to help currently-hospitalized COVID-19 patients.
The hope is any antibodies in their system would help other patients recover faster.
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