Montefiore Health System and Albert Einstein College of Medicine launched a study to evaluate if Remote Patient Monitoring (RPM) is a more effective, efficient and ultimately superior approach to caring for COVID-19 patients in a bid to better track and flag individuals at risk for infection progression. Led by Jonathan D. Leff, MD, FASE, vice chair (Montefiore and Einstein) and Singh Nair, MD, the study involves 150 people monitored by a care team. The prestigious Bronx academic medical centers partnered telehealth provider MonitorMe for this effort. The ultimate goal is more ambitious: the development of an algorithm that helps predict which COVID-19 patients need early intervention.
Although most cases of COVID-19 (e.g. SARS-CoV-2 infection) are mild and simply require staying at home, bed rest (similar to caring for a flu), some scenarios merit the involvement of medical professionals—a care team. For example, some patients, for whatever reason, need more hands-on attention. Whether its an elderly person, one that simply prefers to interact more with health professionals while ill or in some cases individuals actually don’t notice the initial signs that their COVID-19 infection progresses for the worse.
As reported by a local Bronx news outlet called Norwood News, this study is especially concerned with the later point of symptoms associated with a worsening SARS-CoV-2 viral infection. Consequently, the primary goal of the two venerable Bronx academic medical centers: spot early indicators of disease progression, via the identification of abnormal vital signs indicating health degradation in the hopes of anticipating and preventing life-threatening complications before it’s too late writes Sile Moloney for the Norwood News.
Singh Nair, MD, study co-investigator emphasized the importance of remote patient monitoring, commenting, “Our goal is to determine if wearable technologies can play a role in improving care outside the hospital and pinpoint who is most likely to suffer from COVID-19 complications. By doing so, we can be smarter about how we deploy resources and deliver the most informed care.”
Relevance for Research
TrialSite News focus of course is research and not general care. Because this study involves both COVID-19 and remote patient monitoring, the TrialSite curation engine suggested reporting. As clinical trials move from classical pure site-based models to various remote or decentralized models—often called virtual clinical trials—studies evaluating the material impact of remote patient monitoring are of significant interest to TrialSite.
Remote Patient Partner
Montefiore Health System and Albert Einstein College of Medicine have teamed up with a telehealth provider called MonitorMe for this study. MonitorMe’s solution includes a turnkey monitoring service that includes doctors, nurse practitioners, physician assistants, nurses and wellness coaches coupled with the latest telehealth infrastructure.
Based in Poughkeepsie, New York— an hour north up the Hudson River from the Montefiore Medical Center—MonitorMe was the brainchild of Dr. Anthony J. Bacchi, founder of other health tech ventures such as MagnaCare and TeliStat. TrialSite provides more on this company below.
The study includes two groups including the 150 study patients receiving remote care and a group that receives standard outpatient care.
Those participants in the remote patient monitoring arm receive real time, 24 hours a day monitoring. These patients maintain a diary recording symptoms, from coughing to breathing issues, writes Ms. Moloney. The study arm involves the real time monitoring of heart-rate, blood pressure, oxygen levels and temperature. Of great benefit to the study patients, they can immediately access the real-time support associated with the telehealth offering. Should symptoms worsen at any part of the program, the patient can be directly admitted to the hospital.
The study’s other arm, standard outpatient care, consists of individuals’ self-monitoring as well as follow-up calls from the health providers.
The investigators will compare the outcomes of the two groups.
Commenting on the study for Norwood News, a community news outlet in the Bronx, Dr. Neff commented, “We know that the majority of people with COVID-19 fare well recovering at home.” He continued, “However, some people may not be comfortable managing their own symptoms or may not notice when their condition gets worse. Our study will help identify abnormal vital signs associated with declining health and hopefully prevent the development of life-threatening complications before it’s too late.”
Toward Data-driven Care Coordination
The study is actually part of a grander scheme to develop, build and enable a form of artificial intelligence able of actually predicting which individuals with a mild or moderate SARS-CoV-2 infection are at greater risk for viral worsening. Hence the importance of this study and its contribution to an enabling algorithm that can only strengthen over time. Ultimately, health systems such as Montefiore and Einstein will leverage data-driven predictive capability to identify how to allocate precious resources based on risk-based algorithms. Those deemed at risk will receive anticipatory care involving early intervention and enhanced treatment options.
The MonitorMe mission arose from a very personal need, a dilemma Dr. Anthony J. Bacchi faced when caring for his 96-year-old mother. She was an independent woman, who faced growing health-related challenges after Dr. Bacchi’s father passed. Mrs. Bacchi, like many seniors, wanted to age in the comfort of her own home and not in some nursing home or elderly center. With her and her son being a 1.5 hour drive apart, Dr. Bacchi needed an easy way to keep an eye on his mom, including the monitoring of vital signs as she developed Congestive Heart Failure at a later stage of her life. The MonitorMe™ concierge program concept arose out of this challenging situation.
Founded in 2015 by Dr. Anthony Bacchi, the MonitorMe program includes a proprietary patch (purported to be “FDA cleared”) technology along with their “Monitoring Intervention Center (MIC)” allowing clinicians’ access for 24/7/365 monitoring by board-certified ER physicians, Pas, NPs, and specialty-trained RNs.
Jonathan D. Leff, MD, FASE, vice chair, Faculty & Academic Affairs and chief, Cardiothoracic Anesthesiology, Montefiore and professor of anesthesiology and of cardiovascular & thoracic surgery,
Singh Nair, MD, director of Anesthesiology Clinical Research Studies at Montefiore, assistant professor of anesthesiology at Einstein