Royal Melbourne harnesses REDCap for home monitoring during COVID-19

A team from Royal Melbourne Hospital's emergency department has created a platform for home monitoring patients for COVID-19 symptoms using the REDCap data collection tool, and is offering its adaptation for free to other hospitals.

The platform allows the hospital to send an SMS prompt twice a day to patients at home to submit their heart rate, temperature and oxygen saturation, store and analyse these vital signs and alert staff to patients that should be reviewed because of high or low readings.

Developed by emergency physicians Martin Dutch (pictured) and Jonathan Knott with funding from the Peter Doherty Institute for Infection and Immunity, the RMH Home Monitoring platform uses a pulse oximeter and thermometer to measure vital signs, which are entered into the system through a REDCap survey website.

The system is automated so staff interaction and administrative work is minimised, the developers say. REDCap (Research Electronic Data Capture) is a secure web application for building and managing clinical surveys and databases which is free to use by non-profit health organisations under licence.

The RMH adaptation can handle patient registration, patient discharge, automatic prompts, alerts including MET calls if necessary, and keeps clinical notes and medical records. Hospitals will need to provide digital thermometers and pulse oximeters to patients and have a dedicated outgoing SMS service, ideally something like Twilio, along with a dedicated email server and address for staff.

According to RMH, the program was set up to assist with pandemic numbers of COVID patients expected at the hospital. The idea was to use pulse oximeters to effectively monitor patients from their homes and reduce unnecessary admissions.

Patients who don't require hospital treatment can self-quarantine at home but if they begin to deteriorate, their symptoms can be picked up quickly and requested to return to hospital if necessary.

Dr Dutch said the program had the capacity to monitor 1000 patients.

“This is a cheap and effective way of monitoring patients and giving them peace of mind, knowing the hospital is keeping an eye on them when they aren’t physically onsite,” he said.

“COVID-19 provides some unique challenges for the health system. It is now clear that a subset of patients may have a very significant deterioration in their health in their second week of illness.

“This deterioration can often begin to occur silently, without a significant worsening of symptoms. A number of international centres are now recommending the early identification of this subgroup of patients, through use of pulse oximeters in the community.”

He said the costs of setting up a system like this are particularly affordable as the underpinning software is free to use for all health institutions.

The RMH solution can be downloaded from Github and used for free by other hospitals with a REDCap licence.

Photos courtesy Melbourne Health.

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Posted in Australian eHealth

Tags: Royal Melbourne Hospital, Melbourne Health, COVID-19, REDCap

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