Acute remote home monitoring of acutely ill COVID-19 patients: How Dutch home monitoring initiatives were organized during the pandemic

Abstract Background Acute remote home monitoring of acutely ill COVID-19 patients holds potential for early detection of deterioration. Subsequent early intervention may prevent progression to severe illness and need for respiratory support. Methods We performed literature searches (both grey and academic) between 1 March 2020 and 1 March 2023 to identify Dutch acute remote home monitoring initiatives, excluding studies on early discharge from hospital. From the available protocols, we extracted relevant information on patient eligibility, organization of acute remote home monitoring and home management. Results We identified and approached ten acute remote home monitoring initiatives for information on their used protocols. Seven out of ten protocols were retrieved and assessed. Of these, all focused on adult COVID-19 patients at risk of developing severe COVID-19 with high risk of hospitalization and offered close follow-up through remote home monitoring with medically certified pulse oximeters. Measurements included peripheral oxygen saturation (all initiatives), body temperature (all but one), heart frequency per minute (four initiatives) and/or breathing rate per minute (four initiatives). For follow-up and review of measured values, in most initiative (6 of 7) a physician (general practitioner or hospital physician) was supported by a dedicated monitoring center. In 5 of 7 initiatives, the general practitioner (GP) was responsible for supervising patients and monitoring staff. Conclusion The acute remote home monitoring initiatives that emerged in the Netherlands during the first wave of the COVID-19 pandemic were similarly organized. Important key elements for home monitoring are regular daily check of peripheral oxygen saturation, monitoring via a dedicated remote monitoring center staffed with healthcare personnel and supervising physician.