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Comparative Effectiveness of an Automated Text Messaging Service for Monitoring COVID-19 at Home
M Kit Delgado1, Anna U Morgan2, David A Asch3
1Center for Emergency Care Policy and Research, Department of Emergency Medicine, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, and Leonard Davis Institute of Health Economics, University of Pennsylvania, and Center for Health Care Innovation, University of Pennsylvania Health System, Philadelphia, Pennsylvania (M.K.D.).
Remote monitoring for COVID-19 patients using the COVID Watch service significantly reduced mortality. This automated system improved outcomes by facilitating earlier intervention and increased healthcare engagement.
Area of Science:
- Public Health
- Digital Health
- Infectious Disease Epidemiology
Background:
- Most patients with SARS-CoV-2 (COVID-19) can be managed at home, but sudden hospitalization needs can arise.
- Effective remote monitoring strategies are crucial for managing community-dwelling patients with COVID-19.
Purpose of the Study:
- To determine if the COVID Watch automated remote monitoring service for home-isolated COVID-19 patients reduces mortality.
- To assess the association between remote monitoring enrollment and patient outcomes.
Main Methods:
- Retrospective cohort analysis comparing COVID Watch enrollees with eligible controls receiving usual care.
- Propensity score-weighted risk adjustment models were used to compare 30- and 60-day outcomes.
- Primary outcome was 30-day mortality; secondary outcomes included emergency department (ED) visits and hospitalizations.
Main Results:
- COVID Watch enrollment was associated with significantly reduced 30-day mortality (OR 0.32) and 60-day mortality.
- COVID Watch patients experienced 1.8 fewer deaths per 1000 at 30 days and 2.5 fewer deaths per 1000 at 60 days.
- Increased telemedicine encounters, ED visits, and hospitalizations were observed in the COVID Watch group, with earlier ED presentation.
Conclusions:
- Automated remote monitoring for COVID-19 outpatients (COVID Watch) is linked to decreased mortality.
- The benefits may stem from increased telemedicine engagement and earlier emergency department presentation.
- Further research into unobserved confounding factors is warranted.
