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 patients don’t, prompting the facility to roll out a “virtual hospital” for those recovering at home.
About 80 percent of COVID-19 patients don’t need to be hospitalized, and the new initiative provides them with “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 a “Home Treatment Team” provides support from nurses, physicians, pharmacists and other staff who use telemedicine to monitor and care for patients as they recover.
“It’s like the doctor is (visiting) you while you are in the comfort of your own home,” Manning said.
A monitoring kit also is delivered to patients who are recovering at home. It contains a blood pressure cuff and pulse oximeter, which measures a patient’s blood oxygen level and heart rate.
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The kit also includes instructions for self-isolation and symptoms patients should be watching for. The patients then log their vital signs — including temperature, blood pressure and oxygen levels — and discuss any issues they’re managing with a health care provider via a daily telephone check-in.
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.
A patient’s family members also can ask questions or voice concerns during the daily calls.
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 UIHC 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.”
76 SERVED TO DATE
To date, UIHC — which administrators say is one of only a few hospitals 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 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 hospitalized COVID-19 patients.
The hope is any antibodies in the plasma would help patients recover faster.
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