Maria Middelares General Hospital uses telemonitoring for monitoring COVID patients at home

At the end of December 2020, the RIZIV launched a call for projects under the theme of ‘Remote care: monitoring COVID-19 patients at home through telemonitoring’. Based on the belief that this innovative approach will take both the patient experience and the care organisation to the next level, Maria Middelares General Hospital submitted its own project. This has now been approved by the RIVIZ.

During the first wave of COVID-19, Maria Middelares General Hospital already began monitoring 80 COVID-19 patients in their home after hospitalisation or presentation at A&E, based on daily evaluations through questionnaires and video consultations. The hospital is now taking this one step further.

COVID-19 patients who, according to the GP or specialist, can be safely monitored at home, are registered on the central patient platform MyMariaMiddelares, which is based on the Well@Home-platform by BeWell Innovations.. This is equipped with all functions to allow for the efficient monitoring of patients at home in a secure digital environment. The platform has a rating of level M in the validation pyramid of mHealth Belgium.

‘I had been in hospital for a few days already when I was asked to participate in this project. After a clear explanation and in between many coughing fits, I agreed straight away to join. I’m a nurse myself and have a degree of knowledge and background that can support me. This disease is not to be underestimated and thanks to this tool, patients without any (para)medical background can monitor themselves too, in the knowledge that they are also being monitored from a distance. If any irregularities occur, faster intervention is possible so that no valuable time is lost. It is a very clever system... Congratulations to the team that set this up and to the hospital that provides the required support.’

Testimonial from patient Sabine D’Hoop

How does it work exactly?

Through MijnMariaMiddelares, the patient is evaluated daily with the aid of a questionnaire. The questions are about disease parameters, such as fever and breathlessness, but also about mental well being and practical matters such as support within the household. The Rapid Response Team (RRT) of the Maria Middelares General Hospital, consisting of specially trained intensive care nurses and available 24/7, views the data of all registered patients at least three times a day. Participating GPs also receive a daily overview and can follow up their patients proactively.

If a patient reports that their health is deteriorating and alarm signals are triggered, the telemonitoring can be tightened in consultation with the home care nurse of the White and Yellow Cross and the GP/physician who can perform a clinical evaluation. If necessary, the home care nurse shows the patient how they can measure their vital parameters such as oxygen saturation or blood pressure themselves (= discontinuous monitoring every eight hours)

Should the patient’s condition deteriorate further, then the monitoring can, in consultation with the GP, be switched to real-time, continuous monitoring through wearables. These are wearable, wireless measuring devices such as smart watches or biosensors that are incorporated in sticky plasters. On the basis of the automatically captured results that are transmitted wirelessly through Bluetooth, an ESW, or Early Warning Score, is calculated. This score indicates how serious the patient’s condition is and to what degree follow-up is required.

If the condition of the patient becomes more serious, the RRT contacts the patient immediately. The team can call on the expertise of a critical care specialist at all times, and they can also always consult with the A&E physicians and department physicians. Next, they discuss their evaluation with the GP, who either visits the patient themselves or asks the home care nurse to do so. During this check-up, the decision is made to either continue the telemonitoring or to have the patient admitted to the hospital.

Collaboration

For this project, the hospital joins forces with the White and Yellow Cross, GPs and other care providers, enabling them to arrange for seamless care for the patient together. Maria Middelares General Hospital firmly believes that this is the healthcare model of the future.