A silver lining after the pandemic: Home care helps patients detect life-threatening diseases


With fewer medical appointments and more virtualization, patients monitor their health at home and catch rather deadly signs and symptoms, and encourage a movement to get more surveillance equipment into patients’ hands.

It is one of several home programs that are gaining momentum due to the pandemic.

Mom discovers her own preeclampsia

In April, because of Covid-19, Whitney Williams began having less personal appointments with her midwife. So the pharmacist from Lexington, Kentucky, decided to check her blood pressure at home every day.

Williams with her daughter, Emma Rose, two weeks old.

One day her blood pressure was high, and Williams called her doctor, who asked her to come to the office. It turns out she had developed preeclampsia, a condition that can be fatal to both mother and baby.

High blood pressure is a signature symptom, and because Williams caught her on time, she and her baby are well after long hospitalizations.
“If I had not checked my blood pressure at home and reported it to my doctor, who knows if I would have made it to the hospital on time?” Williams wrote in a post on BabyCenter.
In April, the Preeclampsia Foundation launched the Cuff Kit program, which to date has provided more than 2,500 blood pressure cuffs to pregnant women in seven states.
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Eleni Tsigas, CEO of the foundation, notes that even when doctors return to regular personal appointments, the cuffs could catch preeclampsia, which occurs suddenly, between visits. Plus, women can check their blood pressure in the weeks after giving birth, when postpartum preeclampsia can strike and new mothers do not often have appointments from doctors.

The program has been in the works for months, but the pandemic accelerated the launch, Tsigas said.

“There really is a silver lining to Covid-19,” she said.

A watch device helps Covid patients recover at home

When the pandemic began, Dr. Peter Pronovost, chief clinical transformation officer at University Hospitalitals in Cleveland, cared about Covid-19 patients recovering at home, away from careful control.

That his hospital sent patients a device resembling a smart watch, which monitors oxygen levels, heart rate, and respiratory rate. The data is electronically checked by a team of nurses.

Since March, the Pronovost team has distributed more than 1,000 devices to patients in Ohio with confirmed and suspected Covid-19.

The device has already saved the lives of patients such as Leonard Frazier, a resident of a recreation center in Chardon, Ohio. In March, he was at home with coronavirus when his device discovered that his oxygen level dropped and his blood pressure spike. Nurses called him and told him to come to the emergency room immediately.

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After a week in the hospital, Frazier returned and was discharged.

“Home monitoring opens up a whole new pipeline for better diagnosis and makes it visible so we can connect people with care,” Pronovost said. “With the ability to monitor vital signs of patients at home, we can replicate vital signs that are regularly done in the hospital for very low cost at home.”

Pronovost said it was “striking” how the pandemic “created the fierce urgency of now,” as Martin Luther King said. We had to innovate. ‘

Mayo Clinic launches “many Bluetooth devices” program

Doctors at the Mayo Clinic began thinking about a home monitoring program a year ago, but only last month, with the pressure of Covid-19 on their heels, did the program actually launch.

Now patients are at home, charging with devices connected via Bluetooth to Mayo nursing stations. The devices monitor patients’ heart rate, blood pressure, and oxygen levels. A Bluetooth scale sends in its weight.

Next Mayo hopes to use a virtual stethoscope – patients would place it on their heart and a doctor would listen – and an otoscope, which patients would use to show doctors the inside of their ears and mouths.

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“To run a hospital at home, you need a lot of Bluetooth devices to turn a bedroom into a hospital room,” said Maniaci, who runs the monitoring program at home at the Mayo Clinic in Florida.

To date, eleven patients in Florida and Wisconsin, with pneumonia, kidney failure, and other diagnoses, receive care through the program. Mayo hopes to have 60-80 patients in the program by the end of the year, and 600-800 patients by the end of 2021, all monitored by physicians on Mayo campuses in Minnesota, Florida, and Arizona.

“The justification for this was really made by the pandemic,” Maniaci said. “Covid has opened up a realm of virtual medicine that has hardly been used.”

Patients help with reduced access to doctors

Pronovost, the doctor at University Hospitals in Cleveland, said that blood pressure cuffs for pregnant women are a perfect example of low-cost, highly effective home monitoring.

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“A blood pressure cuff costs between $ 10 and $ 30, and we could significantly reduce maternal mortality and neonatal complications because preeclampsia is a major cause of pre-term birth,” Pronovost said.

The effect could be particularly profound for Black women, who have a higher incidence of preeclampsia and have less access to prenatal care.

“Inequality in maternal mortality and neonatal mortality in non-whites versus whites has been morally repaid,” Pronovost said. “This can be a very effective way of tackling health inequalities.

For all expectant mothers, careful monitoring may be helpful.

Williams said she will always be grateful for her blood pressure cuff at home.

Because of her preeclampsia, and an associated disorder called HELLP Syndrome, her doctors had to deliver her baby, Emma Rose, six weeks early. Emma spent more than three weeks in the hospital. So did her mother, who suffered a broken liver.

“I do not know that Emma and I would be here today if I had not checked my blood pressure at home and knew when I would have to go to the doctor,” she said.

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