Evidence map›Paper›PMID 33795222›Full record

ArticleCMAJ open

Adoption, feasibility and safety of a family medicine-led remote monitoring program for patients with COVID-19: a descriptive study.

Payal Agarwal, Geetha Mukerji, Celia Laur, Shivani Chandra, Nick Pimlott, Ruth Heisey, Rebecca Stovel, Elaine Goulbourne, R Sacha Bhatia, Onil Bhattacharyya and 1 more

Abstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Payal AgarwalWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont. payal.agarwal@wchospital.ca.
Geetha MukerjiWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
Celia LaurWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
Shivani ChandraWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
Nick PimlottWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
Ruth HeiseyWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
Rebecca StovelWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
Elaine GoulbourneWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
R Sacha BhatiaWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
Onil BhattacharyyaWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.
Danielle MartinWomen's College Hospital Institute for Health System Solutions and Virtual Care (Agarwal, Mukerji, Laur, Chandra, Bhatia, Bhattacharyya), and Department of Family and Community Medicine (Agarwal, Bhattacharyya, Martin), and Division of Endocrinology & Metabolism (Mukerji), Department of Medicine, and Women's College Hospital Academic Family Health Team (Pimlott, Heisey), Department of Family and Community Medicine, and Division of General Internal Medicine (Stovel), Department of Medicine, University of Toronto; Division of General Internal Medicine (Stovel), Women's College Hospital; Women's College Hospital (Goulbourne, Martin); University Health Network (Bhatia); Dalla Lana School of Public Health (Martin), University of Toronto, Toronto, Ont.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVirtual care for patients with coronavirus disease 2019 (COVID-19) allows providers to monitor COVID-19-positive patients with variable trajectories while reducing the risk of transmission to others and ensuring health care capacity in acute care facilities. The objective of this descriptive analysis was to assess the initial adoption, feasibility and safety of a family medicine-led remote monitoring program, COVIDCare@Home, to manage the care of patients with COVID-19 in the community.

methodsCOVIDCare@Home is a multifaceted, interprofessional team-based remote monitoring program developed at an ambulatory academic centre, the Women's College Hospital in Toronto. A descriptive analysis of the first cohort of patients admitted from Apr. 8 to May 11, 2020, was conducted. Lessons from the implementation of the program are described, focusing on measure of adoption (number of visits per patient total, with a physician or with a nurse; length of follow-up), feasibility (received an oximeter or thermometer; consultation with general internal medicine, social work or mental health, pharmacy or acute ambulatory care unit) and safety (hospitalizations, mortality and emergency department visits).

resultsThe COVIDCare@Home program cared for a first cohort of 97 patients (median age 41 yr, 67% female) with 415 recorded virtual visits. Patients had a median time from positive testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to first appointment of 3 (interquartile range [IQR] 2-4) days, with a median virtual follow-up time of 8 (IQR 5-10) days. A total of 4 (4%) had an emergency department visit, with no patients requiring hospitalization and no deaths; 16 (16%) of patients required support with mental and social health needs.

interpretationA family medicine-led, team-based remote monitoring program can safely manage the care of outpatients diagnosed with COVID-19. Virtual care approaches, particularly those that support patients with more complex health and social needs, may be an important part of ongoing health system efforts to manage subsequent waves of COVID-19 and other diseases.

Indexed as

COVID-19Family PracticeAdultAmbulatory CareCanadaComprehensive Health CareCOVID-19 TestingDisease Transmission, InfectiousFamily HealthFeasibility StudiesFemaleHumansMalePatient Care TeamProgram EvaluationSARS-CoV-2

Identifiers

PMID33795222
PMCPMC8034257

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.