Irvine, California-based Masimo’s study, led by Dr. Hemali Patel and colleagues at the University of Colorado and UC Health (UCH) in Aurora, Colorado, evaluated the impact of remote patient monitoring of COVID-19 patients using SafetyNet on hospital length of stay. Results were published in Telemedicine and e-Health.
SafetyNet uses tetherless Masimo Radius PPG SET pulse oximetry and a smartphone app to transmit continuous, home-based patient monitoring data to hospital clinicians. According to a news release, the study demonstrated a significant association between briefer hospitalization and patients discharged with SafetyNet and without home oxygen.
The researchers concluded that “home telemonitoring after discharge for patients with COVID-19 may be a safe tool that may reduce the mean duration of hospitalization and create more bed capacity,” Masimo said.
From March to June 2020, during the first COVID-19 surge at UCH, the researchers implemented a remote patient monitoring feasibility program with SafetyNet (phase one) and redeployed it during the second surge from October 2020 to February 2021 (phase two). Using SafetyNet allowed researchers to remotely monitor xygen saturation (SpO2), pulse rate, and plethysmographic respiration rate (Masimo RRp) from a continuously staffed virtual health center, with data transmitted via Masimo’s HIPAA-compliant secure cloud service.
The researchers then retrospectively reviewed data for all patients discharged home after COVID-19 admission over the two periods. The discharged patients with and without SafetyNet were compared using a two-to-one-matched case-control design, with patients matched in each time period based on age, sex, Charlson comorbidity index, and limited English proficiency. The primary outcome was hospital LOS, and secondary outcomes were a) 7-, 14-, and 30-day hospital readmission and b) return to the emergency department within 30 days.
In total, 923 patients in phase one were enrolled, with 78 discharged with SafetyNet and 845 without. The second phase enrolled 1,056 patients, discharging 125 with SafetyNet and 931 without. The researchers observed a decrease in length of stay for patients discharged with SafetyNet without an increase in 30-day emergency department revisits or hospital readmission.
There was not a significant association compared to patients discharged without SafetyNet, the researchers described the decrease as a “trend toward an overall lower” length of stay in the hospital. Additionally, they observed an interaction effect between Masimo SafetyNet and home oxygen therapy.
In phase 2, a decrease in length of stay was strongly associated with Masimo SafetyNet patients discharged without home oxygen therapy, compared to non-Masimo SafetyNet patients for whom length of stay decreased by an additional 36%. No other significant interactions were detected.
The researchers said the study supports other work suggesting that home telemonitoring may allow for earlier discharge from the hospital. They did not find a strong association between reduction in length of stay and patients discharged with SafetyNet and with oxygen therapy, saying that was likely “because hypoxia portends a poorer prognosis and often a longer hospitalization.”
“Our results remain relevant as we face yet more surges of admissions of patients with COVID-19,” the researchers said. “Even if the surges decrease, we face hospital capacity difficulties as we navigate ongoing COVID-19 admissions in addition to providing care for non-COVID patients. Home telemonitoring after discharge for patients with COVID-19 may be a safe tool that may reduce the mean duration of hospitalization and create more bed capacity.”
