Remote monitoring in telehealth care delivery across the U.S. cystic fibrosis care network.


Journal

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
ISSN: 1873-5010
Titre abrégé: J Cyst Fibros
Pays: Netherlands
ID NLM: 101128966

Informations de publication

Date de publication:
12 2021
Historique:
received: 16 07 2021
revised: 27 08 2021
accepted: 29 08 2021
entrez: 21 12 2021
pubmed: 22 12 2021
medline: 11 1 2022
Statut: ppublish

Résumé

Cystic fibrosis (CF) programs and people with CF (PwCF) employed various monitoring methods for virtual care during the COVID-19 pandemic. This paper characterizes experiences with remote monitoring across the U.S. CF community. The CF Foundation (CFF) sponsored distribution of home spirometers (April 2020 to May 2021), surveys to PwCF and CF programs (July to September 2020), and a second program survey (April to May 2021). We used mixed methods to explore access, use, and perspectives regarding the use of remote monitoring in future care. By October 2020, 13,345 spirometers had been distributed, and 19,271 spirometers by May 2021. Programs (n=286) estimated proportions of PwCF with home devices increased over seven months: spirometers (30% to 70%), scales (50% to 70%), oximeters (5% to 10%) with higher estimates in adult programs for spirometers and oximeters. PwCF (n=378) had access to scales (89%), followed by oximeters (48%) and spirometers (47%), often using scales and oximeters weekly, and spirometers monthly. Over both surveys, some programs had no method to collect respiratory specimens for cultures associated with telehealth visits (47%, n=132; 41%, n=118). Most programs (81%) had a process for phlebotomy associated with a telehealth visit, primarily through off-site labs. Both PwCF and programs felt future care should advance remote monitoring and recommended improvements for access, training, and data collection systems. PwCF and programs experienced unprecedented access to remote monitoring and raised its importance for future care. Improvements to current systems may leverage these shared experiences to augment future care models.

Sections du résumé

BACKGROUND
Cystic fibrosis (CF) programs and people with CF (PwCF) employed various monitoring methods for virtual care during the COVID-19 pandemic. This paper characterizes experiences with remote monitoring across the U.S. CF community.
METHODS
The CF Foundation (CFF) sponsored distribution of home spirometers (April 2020 to May 2021), surveys to PwCF and CF programs (July to September 2020), and a second program survey (April to May 2021). We used mixed methods to explore access, use, and perspectives regarding the use of remote monitoring in future care.
RESULTS
By October 2020, 13,345 spirometers had been distributed, and 19,271 spirometers by May 2021. Programs (n=286) estimated proportions of PwCF with home devices increased over seven months: spirometers (30% to 70%), scales (50% to 70%), oximeters (5% to 10%) with higher estimates in adult programs for spirometers and oximeters. PwCF (n=378) had access to scales (89%), followed by oximeters (48%) and spirometers (47%), often using scales and oximeters weekly, and spirometers monthly. Over both surveys, some programs had no method to collect respiratory specimens for cultures associated with telehealth visits (47%, n=132; 41%, n=118). Most programs (81%) had a process for phlebotomy associated with a telehealth visit, primarily through off-site labs. Both PwCF and programs felt future care should advance remote monitoring and recommended improvements for access, training, and data collection systems.
CONCLUSIONS
PwCF and programs experienced unprecedented access to remote monitoring and raised its importance for future care. Improvements to current systems may leverage these shared experiences to augment future care models.

Identifiants

pubmed: 34930544
pii: S1569-1993(21)01376-X
doi: 10.1016/j.jcf.2021.08.035
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

57-63

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest There are no conflicts of interest.

Auteurs

Thida Ong (T)

Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, WA, United States. Electronic address: thida.ong@seattlechildrens.org.

Aricca D Van Citters (AD)

The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States.

Christopher Dowd (C)

Cystic Fibrosis Foundation, Bethesda, MD, United States.

Jason Fullmer (J)

DCMG Pediatric Pulmonology & Sleep Medicine, Dell Children's Medical Group, Austin, TX, United States.

Rhonda List (R)

Division of Pulmonary and Critical Care, University of Virginia, Charlottesville, VA, United States.

Shine-Ann Pai (SA)

Marnie Paul Specialty Care Center, Dell Children's Medical Center of Central Texas, Austin, TX, United States.

Clement L Ren (CL)

Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.

Peter Scalia (P)

The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States.

George M Solomon (GM)

University of Alabama at Birmingham, Birmingham, AL, United States.

Gregory S Sawicki (GS)

Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, United States.

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Classifications MeSH