Safer patient monitoring through digital care
Over the years, medical culture has shifted its mindset to focus more closely on patient safety, recognizing the need for better collaboration and communication. With digital-first care, patient safety in the healthcare system is continuing on a path toward zero harm.
Increasing medication adherence
During the COVID-19 pandemic the public, as well as symptomatic patients, were under quarantine orders preventing many patients from seeking care. A study on remote-patient monitoring showed that digital-first care provided a safe and effective option for patients with COVID-19.
In the study, patients who tested positive for COVID-19 were supplied with pulse oximeters and access to a mobile application for remote monitoring and self-reporting of symptoms. A nursing team was also available for in-home visits if needed. This setup allowed clinicians to safely monitor at-home patients for signs of deterioration before the situation became critical. Patients enrolled in the study were significantly older, with a median age of 51, putting them in a higher risk category for hospitalization from COVID-19.
The results of the study showed that remotely-monitored patients requiring admission were admitted to the hospital at a higher rate (14.81% vs 6.89%-7.22% for surrounding areas); they also had a lower rate of ICU admission and spent fewer days in the hospital (6 days vs 10 days). Importantly, mortality rates were also 3-4 times lower for the patients who were remotely monitored compared with those in the general community.
At the end of the study, patients were asked a series of questions about their experiences. An overwhelming 98.9% believed they were well monitored with this process, and the 94.5% of patients who had a fear of COVID-19 felt more reassured after using the app.
As previously reported, the pandemic had a significant and detrimental impact on clinical trials, with over 300 trials disrupted. Digital-first care offers a new way forward with decentralized clinical trials. The first 100% decentralized trial, named DeTAP, demonstrated the utility and ease of this new trial design. DeTAP was a six-month, single-arm, virtual study that recruited 100 patients with atrial fibrillation.All participants were >55 years old and were taking oral anticoagulation medication. Enrollment and participation all took place on an app, through which patients were able to provide consent for the study and relay data from remote blood pressure and electrocardiogram sensors. The app collected the data and enabled reminders, surveys, educational content, and video calls.
Progress of the trial
The trial saw rapid recruitment, with 94% enrollment reached in just 12 days. The primary endpoint, a televisit, was completed by 91% of the study participants. Additionally, patients with lower medication adherence at baseline increased their adherence over the course of the study.
At the end of the study, 86% of participants indicated that they would be willing to enroll in a longer 12-18 month trial.
With better trial enrollment, researchers can collect data on a more diverse population, leading to better health outcomes with medications and evidence-based practices.
Two trials, one conclusion
While digital-first care is still in the early stages, these two trials demonstrate that it can and does improve patient safety. Clinicians and researchers have known that an engaged patient is a healthier patient. To make digital-first care work, we need to understand what patients want digital health to look like and how they want the platforms to work for them.
That is why at Huma we have iterated our platform countless times over the last decade, captured millions of different data points, and collected hundreds of hours of qualitative insights. All of this has helped us build a platform that is intuitive and fun to use.
At the end of the COVID-19 remote-monitoring study, 92.8% of patients reported they found the app easy to use, and only 14.9% needed any help learning how to operate the app.
These important findings show that patients are willing to engage with digital-first health and that this approach towards treatment can have a positive impact on patients’ lives.