Virtual health care for community management of patients with COVID-19.

Objectives: To describe the implementation and early experience of virtual health care for community management of patients with COVID-19. Design: observational cohort study. Setting: large Australian metropolitan health service with established virtual health care program and remote patient monitoring capability. Participants: patients with COVID-19 living within the health service who can self-isolate safely, do not require immediate admission to an inpatient setting, have no major active comorbid illness and can be managed at home or other suitable accommodation. Main outcome measures: care escalation rates, including hospital admission. Results: between 11-29 March 2020, 162/173 (93.6%) locally diagnosed patients with COVID-19 were accepted to the virtual health care program, median age 38y (range 11-79). For the 62 patients discharged during this period the median length of stay was 8 days (range 1-17). The peak of 100 prevalent patients equated to approximately 25 patients per Registered Nurse per shift. Patients were contacted a median of 16 times (range 1-30) during this period, with video consultations used 66.3% of the time; 132/162 (81.5%) patients were monitored remotely. Care escalation rates were low: ambulance attendance, 5 (3%); ED attendance, 4 (2.5%); hospital admission, 3 (1.9%). There were no deaths. Conclusions: community-based virtual health care is feasible for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian context for pandemic management. Health services implementing virtual health care should anticipate challenges with rapid technology deployments and provide adequate support to resolve them including strategies supporting consumer use of health information technologies.

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Virtual health care for community management of patients with COVID-19. (Preprint)

10.2196/preprints.21064 ◽

2020 ◽

Author(s):

Owen Hutchings ◽

Cassandra Dearing ◽

Dianna Jagers ◽

Miranda Shaw ◽

Freya Raffan ◽

...

Keyword(s):

Health Care ◽

Health Service ◽

Hospital Admission ◽

Information Technologies ◽

Care Program ◽

Community Management ◽

Inpatient Setting ◽

Healthcare Associated Infection ◽

Health Information Technologies ◽

Health Care Program

BACKGROUND Virtual health care is emerging as a central strategy to manage large numbers of patients affected by the COVID-19 pandemic, as this can maximise the use of limited clinical resources, reduce pressure on acute facilities and reduce the potential for healthcare-associated infection OBJECTIVE To describe the implementation and early experience of virtual health care for community management of patients with COVID-19. METHODS Design: observational cohort study. Setting: large Australian metropolitan health service with established virtual health care program and remote patient monitoring capability. Participants: patients with COVID-19 living within the health service who can self-isolate safely, do not require immediate admission to an inpatient setting, have no major active comorbid illness and can be managed at home or other suitable accommodation. Main outcome measures: care escalation rates, including hospital admission. RESULTS between 11-29 March 2020, 162/173 (93.6%) locally diagnosed patients with COVID-19 were accepted to the virtual health care program, median age 38y (range 11-79). For the 62 patients discharged during this period the median length of stay was 8 days (range 1-17). The peak of 100 prevalent patients equated to approximately 25 patients per Registered Nurse per shift. Patients were contacted a median of 16 times (range 1-30) during this period, with video consultations used 66.3% of the time; 132/162 (81.5%) patients were monitored remotely. Care escalation rates were low: ambulance attendance, 5 (3%); ED attendance, 4 (2.5%); hospital admission, 3 (1.9%). There were no deaths. CONCLUSIONS Community-based virtual health care is feasible for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian context for pandemic management. Health services implementing virtual health care should anticipate challenges with rapid technology deployments and provide adequate support to resolve them including strategies supporting consumer use of health information technologies.

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Virtual Health Care for Community Management of Patients With COVID-19 in Australia: Observational Cohort Study

Journal of Medical Internet Research ◽

10.2196/21064 ◽

2021 ◽

Vol 23 (3) ◽

pp. e21064 ◽

Cited By ~ 1

Author(s):

Owen Rhys Hutchings ◽

Cassandra Dearing ◽

Dianna Jagers ◽

Miranda Jane Shaw ◽

Freya Raffan ◽

...

Keyword(s):

Health Care ◽

Emergency Department ◽

Cohort Study ◽

Health Service ◽

Care Program ◽

Observational Cohort Study ◽

Community Management ◽

Attendance Rate ◽

Health Care Program ◽

Observational Cohort

Background Australia has successfully controlled the COVID-19 pandemic. Similar to other high-income countries, Australia has extensively used telehealth services. Virtual health care, including telemedicine in combination with remote patient monitoring, has been implemented in certain settings as part of new models of care that are aimed at managing patients with COVID-19 outside the hospital setting. Objective This study aimed to describe the implementation of and early experience with virtual health care for community management of patients with COVID-19. Methods This observational cohort study was conducted with patients with COVID-19 who availed of a large Australian metropolitan health service with an established virtual health care program capable of monitoring patients remotely. We included patients with COVID-19 who received the health service, could self-isolate safely, did not require immediate admission to an in-patient setting, had no major active comorbid illness, and could be managed at home or at other suitable sites. Skin temperature, pulse rate, and blood oxygen saturation were remotely monitored. The primary outcome measures were care escalation rates, including emergency department presentation, and hospital admission. Results During March 11-29, 2020, a total of 162 of 173 (93.6%) patients with COVID-19 (median age 38 years, range 11-79 years), who were diagnosed locally, were enrolled in the virtual health care program. For 62 of 162 (38.3%) patients discharged during this period, the median length of stay was 8 (range 1-17) days. The peak of 100 prevalent patients equated to approximately 25 patients per registered nurse per shift. Patients were contacted a median of 16 (range 1-30) times during this period. Video consultations (n=1902, 66.3%) comprised most of the patient contacts, and 132 (81.5%) patients were monitored remotely. Care escalation rates were low, with an ambulance attendance rate of 3% (n=5), emergency department attendance rate of 2.5% (n=4), and hospital admission rate of 1.9% (n=3). No deaths were recorded. Conclusions Community-based virtual health care is safe for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian setting for pandemic management. Health services implementing virtual health care should anticipate challenges associated with rapid technology deployments and provide adequate support to resolve them, including strategies to support the use of health information technologies among consumers.

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POSYANDU LANSIA SEBAGAI ALTERNATIF PROGRAM PELAYANAN KESEHATAN DI PANTI JOMPO DARUSSA’ADAH DAN AN-NUR DI KOTA LHOKSEUMAWE

JURNAL PENGABDIAN KEPADA MASYARAKAT ◽

10.24114/jpkm.v23i3.7469 ◽

2017 ◽

Vol 23 (3) ◽

pp. 356

Author(s):

Mulyati Sri Rahayu ◽

Meutia Maulina ◽

Yuziani Yuziani

Keyword(s):

Health Care ◽

Health Service ◽

Care Program ◽

The Elderly ◽

Health Examination ◽

Early Detection Of Disease ◽

Community Activities ◽

Health Care Program ◽

Elderly Health ◽

Limited Health

Abstrak Penduduk lansia terus meningkat dari tahun ke tahun sehingga dibutuhkan optimalisasi wahana pelayanan bagi kaum lansia seperti posyandu lansia (poslan). Tujuan pengabdian masyarakat ini adalah untuk mengatasi permasalahan program pelayanan kesehatan poslandi Panti Jompo Darussa’adah dan Panti Jompo An-Nur yang dinilai belum optimal. Selain program pelayanan poslan yang belum optimal, keterbatasan fasilitas kesehatan yang menunjang program tersebut juga masih menjadi kedala. Metode penyelesaian permasalahan dilakukan dengan membentuk kader poslan,sosialisasi poslan, pelatihan tentang tugas 5 meja (pemeriksaan fisik dan kemandirian lansia, pengisian KMS dan keterampilan laboratorium sederhana), praktek pelaksanaan poslan, penyediaan fasilitas alat kesehatan dan laboratorium sederhana serta melaksanakan kegiatan penunjang kesehatan lansia seperti senam lansia. Hasil kegiatan Iptek Bagi Masyarakat (IbM) yang dilaksanakan pada kedua mitra adalah tersedianya sistem pelayanan kesehatan 5 meja pada kedua poslan dan tersedianya kader lansia terlatih serta tersedianya sarana alat kesehatan untuk melakukan pemeriksaan kesehatan fisik dan mental emosional, tersedianya laboratorium sederhana sebagai fasilitas yang digunakan untuk deteksi dini penyakit pada lansia. Kesimpulan dari kegiatan IbM dapat meningkatkan jangkauan pelayanan kesehatan lansia dan terbentuk pelayanan kesehatan yang sesuai dengan kebutuhan lansia sehingga dapat meningkatkan derajat kesehatan lansia. Kata kunci: Posyandu Lansia, Panti Jompo, Pelayanan Kesehatan Lima Meja Abstract The elderly population continues to increase from year to year, so it is necessary to optimize the health care program for the elderly such as the elderly posyandu (poslan). The purpose of the project community service is to overcome the problem of health care program poslan at Panti Jompo Darussa'adah and Panti Jompo An-Nur which considered not optimal yet. In addition to the poslan service program that has not been optimal, the limited health facilities that support the program is also still a flame. The problem solving method is done by establishing poslan cadres, poslan socialization, training on 5 table tasks (physical examination and elderly independence, KMS completion and simple laboratory skills), simulation of poslan, provision of simple medical and laboratory facilities and carrying out elderly health support activities such as Elderly gymnastics. The results of the project community activities on both partners are the availability of a five-table health care system in both posyandu and the availability of trained elderly cadres as well as the availability of health-care equipment to perform physical and emotional mental health examination, the availability of simple laboratories as facilities used for early detection of disease in the elderly. The conclusion of the project community activities can increase the reach of elderly health service and formed health service in accordance with elderly needs so as to improve elderly health degree. Keywords: Elderly Posyandu, Nursing Home, FiveDesk Health Service.

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