Remote Patient Monitoring for Global Emergencies: a case study in COVID-19 patients (Preprint)

BACKGROUND The COVID-19 pandemic has highlighted the critical need for telehealth and remote patient monitoring in healthcare delivery. Despite the growing use of on-body wearable sensors for continuous monitoring and predicting adverse events, such as hospitalizations or falls, their widespread adoption within the healthcare ecosystem remains a significant challenge. While the pandemic has accelerated the acceptance of these technologies, achieving widespread integration requires their sustained incorporation into routine healthcare practices beyond emergency situations. In this study, we extend the application of our previously developed remote patient monitoring system, originally designed for the geriatric frail population, to COVID-19 patients. Our objective is to assess whether the metrics obtained from this system, which includes physical activity and indoor localization sensors, along with vital sign monitoring, can provide additional insights into the recovery trajectory of individuals affected by COVID-19. OBJECTIVE The objective of this case study is to demonstrate that remote patient monitoring systems, can be adapted to diverse patient cohorts during emergencies. We aim to illustrate the ease of deployment, particularly when these systems are already integrated into the existing healthcare ecosystem. METHODS From November 2020 to July 2021, 73 patients were recruited through the UCLA Center for Smart Health after being consented to participate in the study for two weeks. The research concentrated on an exploratory analysis, focusing on the detailed examination of characteristics and behaviors of COVID-19 patients as captured by the remote patient monitoring system. We collected day-to-day changes in the following sensor measurements: daily activity, daily energy expenditure, indoor localization, Sp02, respiratory rate, heart rate, and temperature. RESULTS Out of the 73 patients satisfying the inclusion criteria, 41 successfully adhered to using the monitoring technology, with only 22 providing substantial watch data (>4 hours). Among the participants, 39 used the pulse oximeter, 37 used the thermometer, and 36 utilized respiratory monitoring at night. The study demonstrated an overall increase in patients' activity levels towards the end of the study, with many beginning to leave their homes after two weeks. Additionally, respiratory rates shifted towards healthier lower levels, and oxygen saturation improved. Fatigue and headache were identified as the most prevalent symptoms, followed by cough and loss of smell. CONCLUSIONS The conclusion highlights the critical importance of monitoring patients outside of hospital settings, especially during pandemics when patient travel to hospitals or home visits by healthcare professionals could increase the risk of disease transmission. Studies demonstrating the benefits and efficacy of remote monitoring in home settings can better prepare healthcare professionals for future pandemic events. Continuous monitoring of a wide range of patient metrics, from activities to vital signs, and integrating this data into electronic health records would not only improve accuracy and reduce the burden of data collection but also pave the way for enhanced home care, offering higher quality care at a lower cost.