About 80% of people who are diagnosed with COVID-19 will not need to be hospitalized. But recovering at home without medical professionals nearby can still be a daunting prospect for patients and their families.
UI Hospitals & Clinics has developed a new initiative that provides direct daily care and support from a team of medical specialists for patients with COVID-19 who are self-quarantined at home. The Home Treatment Team (HTT) is a multidisciplinary team of nurses, physicians, pharmacists, and support staff who use telemedicine to monitor and care for these patients as they recover at home.
“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,” says Bradley Manning, MD, clinical assistant professor of internal medicine and a hospitalist with UI Health Care.
“It’s like the doctor is rounding on you while you are in the comfort of your own home,” he adds.
Patients diagnosed with COVID-19 at UI Hospitals & Clinics who are well enough to recover at home are assessed by a nurse over the phone. The same day, the patient receives a monitoring kit delivered to their home. The kit contains a blood pressure cuff and a pulse oximeter (to measure blood oxygen and heart rate), along with instructions for self-isolation and which symptoms to monitor. The patient logs their vital signs—temperature, blood pressure, and oxygen levels—and is “visited” daily by a health care provider from the HTT who contacts them by phone.
The phone visit allows the health care team to monitor the patient’s progress in real time to prevent disease complications and quickly intervene if a patient’s condition worsens. The visits are also a chance for the patient or family members to discuss concerns or ask questions.
In addition to providing a higher level of care to patients recovering at home, the approach has also revealed some important observations about how COVID-19 disease affects people. In particular, a high proportion of UI Hospitals & Clinics patients have experienced unpleasant taste and fever. Sometimes, these are the only symptoms in the early phase of the disease. These symptoms can make it difficult for patients to consume adequate food or fluids, which can lead to dehydration.
“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 says. “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.”
Manning says patients are told to drink enough fluids to ensure a light-yellow colored urine. The daily report of the patient’s blood pressure, heart rate, and urine volume allows the team to track their hydration in real time and intervene if necessary.
UI Hospitals & Clinics is one of only a handful of hospitals across the country using this innovative approach to care for patients with COVID-19 who do not need in-hospital care. So far, 76 patients have used the program. Of those, 35 have recovered, 38 are currently being monitored by a nurse or doctor, depending on the severity of their condition; and three have been transferred from home to the hospital for more intensive care.
The hope is this approach will help patients beat the disease while they stay at home rather than having to come into the hospital. That in turn may keep more hospital beds available for those patients who do need a more intensive level of care.
“We are encouraged by our preliminary results,” Manning says. “We would recommend that 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.”