Related Experiment Video
Updated: Jun 14, 2025
Remote Laboratory Management: Respiratory Virus Diagnostics
Published on: April 6, 2019
A Randomized Trial of At-Home COVID-19 Tests, Telemedicine, and Rapid Prescription Delivery for Immunocompromised
Julia Moore Vogel1, Ting-Yang Hung1, Erin Coughlin1
1Scripps Research Translational Institute, Scripps Research, La Jolla, CA.
Objective:
To evaluate whether access to at-home COVID-19 tests, telemedicine, and same-day prescription delivery could reduce COVID cases, hospitalizations, and the cost of COVID care for the high-risk populations using a randomized controlled trial.
Patients And Methods:
Individuals participated remotely between December 1, 2022, and May 16, 2024, with half (n=346, 51.5%) receiving the option to access 10 at-home COVID-19 tests per month for themselves and others in their household as well as telemedicine and same-day Paxlovid delivery, and half (n=325, 48.4%) following their standard testing and treatment practices. Outcome data were collected from surveys, electronic health records and claims.
Results:
Intensive care unit admissions were significantly reduced for intervention participants vs control participants (0.3% vs 4.6%, n=1 vs 13; P<.001). Reported COVID case incidence did not differ significantly (19.0% vs 20.4%, n=59 vs 58; P=.69), nor did hospitalizations (5.2% vs 7.7%, n=15 vs 22; P=.14). The intervention was estimated to result in a reduction of $3650 in the cost of COVID care per person. The specific intervention used is no longer available in the market and alternatives should be considered. Evolution of SARS-CoV-2 could change the effect observed. Survey completion was higher in the intervention group.
Conclusion:
In immunocompromised individuals and those at least aged 65 years, access to at-home COVID tests, telemedicine, and rapid Paxlovid delivery reduced the severity of COVID-19 infections, as reflected by a reduced need for intensive care unit admissions; this has the potential to reduce the cost of COVID care.
Trial Registration:
clinicaltrials.gov Identifier: NCT05655546.
Related Concept Videos
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:27Tumor Immunotherapy