Virtual ward created in patients’ homes in pioneering COVID@HOME project
Digital technology allows patients’ condition to be monitored remotely and continuously
In a new program that’s the first of its kind in Quebec, certain patients are returning home from the JGH, but are continuing to receive hospital care via digital technology.
Known as COVID@HOME, the program allows specific COVID-19 patients to be discharged if their recuperation is progressing well. Their home becomes a virtual ward, where vital signs and other aspects of their recovery are regularly and remotely monitored by a hospital care team.
The project was launched in mid-January by CIUSSS West-Central Montreal and is currently in its pilot stage. If everything unfolds as anticipated, it is likely to become an ongoing aspect of care during and after the COVID-19 pandemic.
A project of this type has been envisioned for some time, since it is in line with the CIUSSS’s increasing use of digital technology in health care. It also conforms with the CIUSSS’s approach of delivering “Care Everywhere” —that is, providing care in whichever setting is safest, most convenient and most comfortable for the patient.
However, the development of COVID@HOME was accelerated during the latest phase of the pandemic, so that some of the patients who were treated for COVID-19 could conclude their recovery in the comfort of home.
Since these patients can be discharged more quickly, hospital beds are available more promptly for newly admitted patients who require urgent care, whether they have COVID-19 or not.
“With COVID@HOME, we’re taking the next major step in our continuing efforts to use digital technology to enhance patient-centred care,” says Dr. Lawrence Rosenberg, President and CEO of CIUSSS West-Central Montreal.
“Our objective is to maintain the human touch that is essential in medical care, while taking full advantage of new digital tools to provide that care with the patient’s safety and comfort in mind.”
“This project is a perfect example of why our CIUSSS considers the concept of ‘Care Everywhere’ to be so integral to patient care,” says Francine Dupuis, the CIUSSS’s Associate CEO. “The objective is to provide the patient with the best possible care, but this does not necessarily mean that the care has to be delivered in a hospital setting.
“With COVID@HOME, a proper level of care is provided in the comfort of the patient’s home, supplemented by in-person visits from our home care team, if necessary.”
Erin Cook, the CIUSSS’s Associate Director of Quality, Transformation, Evaluation, Performance and Ethics, says she is impressed with “how quickly the organization rallied together around this initiative.
“Within just a few days, multiple clinical and support directorates were involved in helping to get this program off the ground. This is really testimony to the maturity of the organization and our ability to pull together as a team.”
COVID@HOME allows specific COVID-positive patients to be discharged to what is, in effect, a hospital in their own home. They become part of a virtual ward, with their health and well-being monitored by a virtual team of nurses, physicians and respiratory therapists.
The typical participant in COVID@HOME is a patient in stable condition who has a COVID-19 diagnosis and requires a short period of monitoring. This may also include administering low levels of oxygen and some oral medication.
To participate, the patient must have a relative or other caregiver who can be relied upon for support. As well, it is preferable for the patient to live in the area served by CIUSSS West-Central Montreal, in case certain types of services—such as home care visits—need to be provided.
These are just a few of the main criteria, but many more conditions must be met before a patient can safely qualify for the project. Worth noting is that a patient becomes a participant only if he/she consents to do so. Everything is done to ensure the patient’s safety and comfort at home, in line with the CIUSSS’s emphasis on patient-centred care.
Before leaving the hospital, the patient and caregiver are thoroughly trained in the use of the digital technology. They also meet their virtual nurse and are informed how to make contact on a 24/7 basis if questions or concerns arise, and what to do in case of an emergency. A smartphone will even be lent to any patient who does not already have one.
While at home, the patient wears a wrist device (similar to a watch), a patch that adheres to the chest, or an oxygen saturation probe that regularly measures vital signs. The first two of these three devices automatically send the data to the virtual care team.
Several times a day, the virtual doctor and nurse contact the patient by phone or on a digital visual platform to check on his/her progress.
COVID@HOME was developed by the CIUSSS as joint effort by physicians, Nursing, Pharmacy, Information Technology, Logistics, Professional Services, the Support Program for the Autonomy of Seniors, the Quality team, the Command Centre, Digital Health and Human Resources, with thanks to the generous support of visionary donors to the JGH Foundation.