Mayo Clinic COVID-19 patients likely had better outcomes thanks to RPM
Research published this week in Mayo Clinic Proceedings found that COVID-19 patients who received care at Mayo Clinic had favorable outcomes compared to those reported nationally.
One factor contributing to those favorable outcomes, said researchers, was the clinic's remote monitoring capabilities allowing for early detection of complications or clinical deterioration.
"By including subject matter experts from a range of disciplines in our treatment teams, and having those treatment teams reviewing the care and progress of each patient daily, our outcomes were better than what had previously been reported," said Dr. Andrew Badley, chair of Mayo Clinic's COVID-19 Research Task Force, in a statement.
WHY IT MATTERS
Health systems have routinely turned to remote monitoring for patients as clinical resources thinned.
According to the Mayo Clinic, 7,891 COVID-19-positive patients who were treated between March 1 and July 31 were included in the research. Of those, 897 required hospitalization and 354 needed ICU treatment.
An overall mortality rate of 1.1% was reported for patients treated at Mayo, with an in-patient mortality of 7.1% and an ICU mortality of 11.9%.
"Rates of mortality reported in hospitalized patients vary widely, but have consistently been higher than what was observed here," wrote the researchers.
At the Mayo Clinic, most of the patients who were treated were not part of the first wave of infections, which allowed physicians to use best practices from other hospitals, researchers said. They also pointed out that selection bias over time (with testing prioritized for those with specific symptoms) may have contributed to declining mortality rates overall.
As part of its COVID-19 treatment plan, the clinic developed a virtual clinic for outpatient care in conjunction with a nurse phone line. Patients deemed at high risk were offered remote monitoring with Bluetooth-enabled pulse oximeters, blood pressure cuffs and thermometers.
"All patients received initial nursing calls discussing the importance of isolation and follow up calls (day 2, 7 and 14) to monitor for possible progression," said researchers. "Physicians assessed the need for care escalation when signs or symptoms worsened. Patients who declined remote monitoring or were lower risk received telephone follow-up with a dedicated nursing team.
"The high proportion of our patients able to participate in these programs was likely a contributor to our outcomes," they added.
THE LARGER TREND
The novel coronavirus pandemic has accelerated the adoption of no-contact patient monitoring, with stretched-thin hospital systems and the need for social distancing pushing patients and providers to use remote tools.
That said, those tools aren't foolproof. A recent study found that pulse oximeters – frequently used in medical decision-making – may be less accurate among Black patients.
ON THE RECORD
"As this global pandemic approaches its first anniversary, we should be heartened by the advances that have been made in testing, diagnosis and management of COVID-19 and its complications," said Badley. "By adopting best practices learned from all institutions, we can continue to improve outcomes for patients."