GetWell Loop, a remote patient monitoring (RPM) and education system added resources about COVID-19 for patients at M Health Fairview, an academic healthcare system in urban Minnesota.
M Health Fairview
- Academic Medical Center
- Community health system
- Digital health platform
- Electronic medical record
Team Members Involved
- Clinical Informatics Specialist
- Clinical Trainee or Student
- Before the COVID-19 outbreak, GetWell was used to educate patients in post-surgery recovery about monitoring pain control, diet, and self-care.
- After the outbreak, GetWell loop was modified to provide information about COVID-19 to select patients who were referred to GetWell after a telehealth visit, emergency room encounter, or office visit related toCOVID-19. Any patients with confirmed or suspected COVID-19 received system communications informing providers in using GetWell as a care option.
- Patients received email instructions on activating the COVID-19 GetWell Loop.
- Nurse educators reaching out to flagged patients who had not yet activated their accounts to provide additional support.
- GetWell loop has a scrolling news feed which provides patients information on COVID-19, reminders about safe social distancing and hygiene practices, and a daily check-in questionnaire to assess symptoms.
- Patients could also send personal comments and questions to their care team.
- Any concerning answers in the symptom monitoring questionnaire were flagged with a red or yellow alert for action by a first responder.
- This intervention was staffed by a virtual health rotation at the University of Minnesota including medical students and local residents (and when even busier, nurse practitioners). This rotation covered the main workforce from 8 AM to 5 PM – peak volume of patient responses.
- Faculty supervising physicians responded to patients with texts or a phone call if a flagged alert was particularly worrying or complicated.
- The workforce was expanded to provide 24/7 virtual care to respond to urgent but after-hour patient alerts.
- Patients could opt out at any time if they lost interest or their COVID-19 symptoms resolved. Patients who successfully completed the GetWell COVID-19 loop were given a satisfaction survey.
- 3701 patients were offered enrollment in the GetWell Loop RPM solution between March 18th and April 20th, 2020.
- 2255 (61%) of these patients enrolled in the program.
- 1496 (40%) of these patients completed the program.
- 757 (20%) of these patients are currently active in the program.
- 10,770 patient check-ins were registered within the RPM solution.
- 94% of enrolled patients checked in at least once.
- On average, each patient had 1 alert and 2 comments throughout enrollment.
- Within enrolled patients, 91 required an emergency department visit and 13 required hospital admission.
- From among patients contacted as part of the program, 92% had not been tested, 7.2% tested negative, and 1% tested positive.
- GetWell Loop typically requires a four-to-six month rollout process, but was condensed into two weeks, limiting the adaptation of additional, potentially benefit features.
- While the initial manual enrollment process was inefficient, additional features were added to automate steps of the enrollment process.
- GetWell Loop had extremely limited customization ability, limiting the ease of introducing simple but powerful improvements.
- In staffing the virtual health rotation, it was a challenge to accurately titrate the student and resident team to ensure adequate staffing and match the variable number of enrolled patients and messages at a time.
- Tucker Annis, Susan Pleasants, Gretchen Hultman, Elizabeth Lindemann, Joshua A Thompson, Stephanie Billecke, Sameer Badlani, Genevieve B Melton, Rapid implementation of a COVID-19 remote patient monitoring program, Journal of the American Medical Informatics Association, Volume 27, Issue 8, August 2020, Pages 1326–1330, https://doi.org/10.1093/jamia/ocaa097