The University of Miami Health System has launched the UHealth Televigilance program, allowing providers to remotely monitor and care for COVID-19 patients who might otherwise need to be admitted as inpatients.
The program involves arming discharged patients with TytoCare home health devices, which they and their caregivers use to electronically transmit timely health status information. Providers monitor patients’ vital signs and can quickly address problems or triage patients who need higher levels of care.
“It’s important to conserve hospital resources and make sure the beds in our hospital are being used for patients who really need that high acuity level of care,” said Sabrina Taldone, M.D., M.B.A., medical director of the UHealth Televigilance program and associate program director of the Internal Medicine Residency Program at the Miller School of Medicine. “This innovative program helps free hospital beds without sacrificing quality of care.”
The device regularly monitors patients’ temperature, blood pressure, heart rate, and oxygen saturation. If providers see data that concerns them, they can follow up with a telemedicine visit and conduct a thorough examination. The patient or caregiver uses device adapters to allow Dr. Taldone and other providers to examine the patient’s heart, lungs, skin, mouth, and ears.
The TytoCare device is integrated with Epic, UHealth’s Electronic Medical Record system. This allows UHealth to apply computer logic to patients’ clinical data, which also helps to alert providers when a value is out of normal range, according to David W. Reis, Ph.D., chief information officer at the University of Miami Health System.
“It brings another layer of data review and analysis for the patient, and makes it easier for our clinicians to rapidly respond when they see something that looks out of range,” Dr. Reis said.
UHealth began distributing the TytoCare devices free of charge to eligible patients on July 10. The plan is to distribute seven to 10 of the devices a week.
“Specifically, these have been given to the COVID-19 pneumonia patients, who have gone home on oxygen and may have borderline vital signs and comorbidities,” Dr. Taldone said.
A candidate for the technology might be a patient in the UHealth emergency department with COVID-19 pneumonia, who isn’t necessarily sick enough to be admitted to the hospital but would do well with a provider following up and making sure that the patient isn’t getting worse. Inpatients who are eligible for the program include those who have been hospitalized for a significant length of time and need close follow-up at discharge.
“So far, the program has been successful and none of our patients have had to come back to the emergency department,” Dr. Taldone said.
Miami resident Tomas Camacho and his son Thomas, who is caring for the elder Camacho, are using the TytoCare device.
Tomas Camacho was discharged from UHealth Tower with oxygen, after staying several days in the hospital with COVID-19 pneumonia. His son recalls feeling stressed when his 73-year-old father came home because he wasn’t sure how to monitor his progress.
“The [TytoCare] device has been amazing because we’ve been able to send all the information directly to the doctor, and she has contacted us and been very helpful in everything. It gives you a little ease,” Thomas Camacho said. “It’s pretty simple to use.”
Receiving vitals data from the device helped Dr. Taldone avoid a readmission when Tomas Camacho’s blood pressure dropped.
“Like many caregivers, Thomas really didn’t understand how to use the oxygen. His dad also had restarted his home medications and one of those medications dropped his blood pressure pretty severely,” Dr. Taldone said. “So I spoke with the son about each of these concerns. We were able to avoid a readmission, as well as decrease Mr. Camacho’s length of stay.”
Patients or caregivers need to have access to a smartphone or tablet and a Wi-Fi network. Once they’re trained in how to use the device, patients or caregivers need to be able to perform vitals measurements using the technology.
“The UHealth Televigilance program decreases length of hospital stay, prevents readmissions, relieves patients’ and caregivers’ anxiety, and uses far fewer resources than are needed when a patient is hospitalized. It does all this while increasing hospital capacity for those who need it most,” Dr. Taldone said.
“Even as the pandemic subsides, the UHealth Televigilance program is going to be excellent for helping with transitions of care. UHealth is about being on the cutting edge and being there for our community, and this is a great way for us to do that.”
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