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Concerns about preventing infection — as well as other stresses on the health care system due to the COVID-19 pandemic — have prompted innovative approaches to patient monitoring and triage. A large health care system in Philadelphia developed a simple, automated, twice-daily texting tool (COVID Watch) that queried enrolled SARS-CoV-2–positive patients regarding health status; those with worsening symptoms were contacted by a health care provider for further assessment. Now, investigators report outcomes from March 23 to November 30, 2020, in 3488 COVID Watch enrollees compared with 4377 SARS-CoV-2–positive patients who received standard care.
Almost 87% of COVID Watch participants responded to at least one text, and in 14% of these, the response elicited contact from an RN. More telemedicine and emergency department visits occurred in the COVID Watch group within 30 days. The overall number of deaths at 60 days was small: 16 (0.37%) in usual care and 5 (0.14%) in COVID Watch, with 2.5 fewer deaths per 1000 patients in the COVID Watch group. No deaths outside of the hospital occurred in the COVID Watch group versus 6 (37.5%) in the usual care group.
Delgado MK et al. Comparative effectiveness of an automated text messaging service for monitoring COVID-19 at home. Ann Intern Med 2021 Nov 16; [e-pub]. (https://doi.org/10.7326/M21-2019)
Comment
COVID-19 is an unpredictable disease, and tools such as automated text messaging (or wearable signaling devices) to allow home monitoring represent attractive triage options directed at those most in need of in-person evaluation and treatment.