2022 Quality




Hospital Quality Improvement Showcase - Froedtert & the Medical College of Wisconsin, Milwaukee

Remote Patient Monitoring for COVID-19 Provides Comprehensive Care and Support 24/7

Innovative technology gives those who test positive for COVID-19 24/7 access to an expert care team virtually, keeping patients out of hospitals.

COVID-19 is a disease with symptoms that can span weeks or even months. Having 24/7 access to a care team can provide support and guidance and even save a trip to the hospital. Through remote patient monitoring, those who test positive for COVID-19 who need medical attention but do not need to be hospitalized are supported by providers who can triage and facilitate in-person care, if needed.

“Many people who test positive for COVID-19 do not require inpatient care but can benefit significantly from on-demand access to their care team,” said Erin Green, RN, executive director of clinical operations at Inception Health, the innovation arm for the Froedtert & the Medical College of Wisconsin health network. “With remote patient monitoring and associated tools, we are further able to extend support beyond the acute phase of a patient’s COVID-19 journey—recognizing that recovery is more often a marathon, not a sprint.”



What is remote patient monitoring?
Remote patient monitoring is a way for health care providers to deliver comprehensive care to patients outside of the traditional hospital. Communicating through a secure app or platform on a computer, tablet or smartphone, patients can share their symptoms and other important information about their health status with providers who make recommendations for care.

Within the Froedtert & MCW health network, remote patient monitoring is managed virtually by a team of expert nurses who specialize in this unique way to deliver care. The nurses communicate with patients through the GetWell Loop app. Before the COVID-19 pandemic, GetWell Loop was in place to monitor patients with chronic conditions, such as hypertension or diabetes. However, in early 2020, the health network started using the platform for COVID-19 patient care.

“Through daily screenings, symptom checks and a direct line to our team, we are able to monitor patient progress, detect early signs of decline and intervene proactively to avoid hospital admissions,” Green said.

The platform has two care plans to support people who are receiving care for COVID-19 on an outpatient basis: the COVID-19 Acute Symptoms or Exposure plan and the COVID-19 Pediatric plan. There is a third care plan, COVID-19 Recovery, for people who were previously admitted to the hospital for COVID-19 and have since been discharged. This remote patient monitoring service is available to patients at no additional cost.

Benefits of Remote Patient Monitoring Throughout the COVID-19 Pandemic

  • Access to 24/7 phone support from a critical care nurse with access to health records and care team

All Froedtert & MCW COVID-19 patients receive information about how to use the remote monitoring service and a phone number to the helpline virtual care nurse on call.

“Unlike some digital monitoring tools, this is not an outsourced solution,” Brad Crotty, MD, Froedtert & MCW internal medicine physician, chief digital engagement officer for the health network and the chief medical officer for Inception Health. “These are Froedtert & MCW nurses who understand what you’re going through, have the context of your health record and can be in touch with your care teams as needed.”

Biometric values such as oxygen saturation level, temperature and heart rate are important vital signs to monitor for COVID-19 patients. Using their own pulse oximeter, thermometer and heart rate monitor, patients enrolled in the remote patient monitoring service can input these values into the app daily, as well as any symptoms, such as shortness of breath or nausea. They can also direct message the virtual care team nurses with questions or concerns. Alerts are triggered in the platform for any concerning changes, which will may result in a virtual care team nurse reaching out to the patient with a phone call.

“While designed as an asynchronous support tool, our remote patient monitoring service allows for the virtual care team to quickly identify new or worsening symptoms. We are then able to provide specific guidance using the patient’s electronic health record,” Green said. “We have a purposeful triage, intervention and escalation plan, as well as a robust relationship with our access center team. This means that if we are directing a patient to seek a higher level of care, we can provide a warm hand-off to the receiving team. This allows for fluid streamlined care and a seamless transition for the patient.”

The self-isolation and stress associated with a COVID-19 diagnosis can affect mental health. Virtual care nurses can connect patients who may benefit from mental health support resources to SilverCloud, another digital health tool available through the Froedtert & MCW health network.

  • Reduced odds of being hospitalized with COVID-19
Research is underway to quantify the benefits of remote patient monitoring for COVID-19. Several studies that have already been published show that COVID-19 patients in a remote monitoring program have a lower hospitalization rate. This is also the case for Froedtert & MCW patients—according to Inception Health’s preliminary data, a Froedtert & MCW patient’s odds of being hospitalized with COVID-19 are 30% lower if they are undergoing remote monitoring. The lower hospitalization rate is not associated with a higher mortality rate.

“We believe therapies available for COVID-19, such as monoclonal antibody therapy, are only a small factor reflected in our data,” Dr. Crotty said. “A large part of our success is due to our nurses being able to provide good and helpful information around self-care at home, including proning, or laying on your stomach, to allow for more air in the lungs, which was one of the more effective ways identified early on of treating hypoxia (lack of oxygen) in COVID-19 patients.”
 
  • The right care at the right time
The COVID-19 pandemic has led to an unprecedented strain on hospitals across the United States. In January 2022, Wisconsin recorded a record-breaking number of new COVID-19 cases. More than half of hospitals in Wisconsin were at overall peak capacity, with more than 90% of the state’s hospital beds in use and nearly 95% of the state’s ICU beds in use, according to the Wisconsin Department of Health Services. Remote patient monitoring gives people who do not need a hospital bed the convenience and comforts of hospital-level care at home, while providing the most critical patients with all of the resources in a hospital setting.

“If we can prevent people from becoming so sick that they would need to be admitted, we consider this a win,” said Dr. Crotty. “Remote patient monitoring allows us to right-size care and treat people in the most effective setting possible through a simple and personalized digital experience.”

Triggered by alerts within the remote patient monitoring platform, Froedtert & MCW virtual care nurses have reached out to patients more than 2,000 times, according to October 2021 data from Inception Health.

“Without the opportunity to speak with one of our nurses, consider that these patients might have unnecessarily gone to the Emergency Department,” Green said. “Remote patient monitoring is a critical tool. We can meet patients where they are at in their journey, provide the type of care they need in their recovery and help them manage their COVID-19 diagnosis at home.”