Hope in the face of the pandemic: Home care helps patients spot life-threatening illnesses

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With fewer in-person medical appointments and more virtual appointments, patients are monitoring their health at home and detecting life-threatening signs and symptoms earlier, triggering a move to put more monitoring devices in between. the hands of patients.

It is one of the many home programs that is gaining momentum due to the pandemic.

Mom detects her own preeclampsia

In April, due to Covid-19, Whitney Williams started having fewer in-person appointments with her obstetrician. The pharmacist in Lexington, Ky. Decided to start checking her blood pressure daily at home.

Williams with her two-week-old daughter Emma Rose.

One day his blood pressure was high and Williams called his doctor, who asked him to come to the office. It turns out that she had developed preeclampsia, a disorder that can be fatal for both mother and baby.

High blood pressure is a hallmark symptom, and because Williams caught hers on time, she and her baby are doing well after long hospital stays.

“If I hadn’t checked my blood pressure at home and reported it to my doctor, who knows if I would have arrived at the hospital on time?” Williams wrote in an article on BabyCenter.

In April, the Preeclampsia Foundation launched the Cuff Kit program, providing more than 2,500 blood pressure cuffs to pregnant women in seven states to date.

Eleni Tsigas, CEO of the foundation, noted that even if doctors return to regular in-person appointments, the handcuffs could catch preeclampsia, which comes on suddenly, between visits. Additionally, women can check their blood pressure in the weeks after birth, when postpartum preeclampsia can occur and new mothers do not have frequent doctor visits.

The program had been underway for months, but the pandemic has accelerated its launch, Tsigas said.

“There really is a silver lining to Covid-19,” she said.

Watch-like device helps Covid patients recover at home

When the pandemic began, Dr Peter Pronovost, head of clinical transformation at Cleveland University Hospitals, was concerned that patients with Covid-19 were recovering at home, far from close monitoring.

So his hospital sent patients a device that looks like a smart watch, which monitors oxygen levels, pulse and respiratory rate. The data is monitored electronically by a team of nurses.

Since March, the Pronovost team has distributed more than 1,000 devices to patients in Ohio with confirmed or suspected Covid-19.

The device has previously saved the lives of patients like Leonard Frazier, a janitor at a recreation center in Chardon, Ohio. In March, he was at home with coronavirus when his device detected his oxygen levels were dropping and his blood pressure was rising. The nurses called him and told him to come to the emergency room immediately.

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After a week in the hospital, Frazier recovered and was discharged.

“Home monitoring opens up a whole new pipeline for better diagnostics and makes them visible so that we can connect people to care,” Pronovost said. “With the ability to monitor the vital signs of patients at home, we can replicate the vital signs that are performed regularly in the hospital at a very low cost at home.”

Pronovost said it was “striking” to see how the pandemic created “the fierce urgency of the moment,” as Martin Luther King put it. We had to innovate.

Mayo Clinic starts program with “a large number of Bluetooth devices”

Doctors at the Mayo Clinic started thinking about a home surveillance program a year ago, but it was not until last month, under pressure from Covid-19 at their heels, that the program was launched. .

Patients are now at home, loaded with devices connected via Bluetooth to Mayo care stations. The devices check patients’ heart rate, blood pressure, and oxygen levels. A Bluetooth scale sends their weight.

Next, Mayo hopes to use a virtual stethoscope – patients would place it over their hearts and a doctor would listen – and an otoscope, which patients would use to show doctors the inside of their ears and mouth.

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“In order to run a home hospital, you need a lot of Bluetooth devices to turn a room into a hospital room,” said Maniaci, who runs the home monitoring program at the Mayo Clinic in Florida.

So far, eleven patients in Florida and Wisconsin with pneumonia, kidney failure and other diagnoses are receiving care under the program. Mayo hopes to have 60 to 80 patients in the program by the end of the year and 600 to 800 patients by the end of 2021, all being followed by doctors at the Mayo campuses in Minnesota, Florida and the ‘Arizona.

“The justification for this has been made real by the pandemic,” Maniaci said. “Covid has opened up a field of virtual medicine that was barely used before.”

Help patients with reduced access to doctors

Pronovost, the physician at Cleveland University Hospitals, said blood pressure cuffs for pregnant women are a perfect example of very effective and low-cost home monitoring.

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“A blood pressure cuff costs between $ 10 and $ 30, and we could dramatically reduce maternal mortality and neonatal complications, as preeclampsia is a major cause of preterm birth,” Pronovost said.

The effect could be particularly profound for black women, who have a higher incidence of preeclampsia and have less access to prenatal care.

“The inequalities in maternal and neonatal mortality among non-whites compared to whites are morally wrong,” Pronovost said. “This could be a really effective way to tackle health inequalities.

For all expecting mothers, careful monitoring can help.

Williams said she would always be grateful for her home blood pressure cuff.

Due to her preeclampsia and an associated disorder called HELLP syndrome, her doctors had to deliver her baby, Emma Rose, six weeks earlier. Emma spent more than three weeks in the hospital. Her mother too, who suffered a broken liver.

“I don’t know Emma and I would be here today if I hadn’t checked my blood pressure at home and didn’t know when to go to the doctor,” she says.

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