Back to Top Skip to main content Skip to sub-navigation

Remote monitoring program enables COVID-19 patients to recover at home

Two medical personnel, wearing masks, looking at the contents of a home-based COVID treatment kit Mike Lavers, sleep technician, and Sgt. 1st Class Annabelyn Verdeflor, noncommissioned officer in charge of the Pulmonary Clinic, look over the components of a home healthcare kit as part of the COVID-19 Remote Monitoring Program, a joint effort of the Virtual Medical Center and Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Dec. 16, 2020. (Photo by Elaine Sanchez, Brooke Army Medical Center.)

Recommended Content:

Public Health | Coronavirus | Innovation | Nurses Week

Kathlyn Chassey was shocked when she was diagnosed with COVID-19 after experiencing a low-grade fever and a bad headache.

A former lung transplant recipient, Chassey had been staying close to home for months to avoid the respiratory risks associated with the virus. She figured she had an infection or the flu when she arrived at Brooke Army Medical Center’s Emergency Department at Joint Base San Antonio-Fort Sam Houston in Texas.

“When the doctor told me I had COVID, I had a panic attack because I’m extremely high risk and I know what COVID can do,” said Chassey, who had undergone a lung transplant in December 2016.

Fortunately, the 28-year-old had a mild case of COVID-19 and was ready to be discharged after a day in the hospital. However, due to her medical history, her medical team didn’t want to send her home empty-handed.

Chassey became one of the first BAMC patients to be enrolled in the new COVID-19 Remote Monitoring Program, a joint effort of the Virtual Medical Center and BAMC. The program equips COVID-19 patients needing additional monitoring with a home healthcare kit and 24/7 oversight from registered nurses to ensure a higher level of post-hospital care.

“This is an exciting and unique new capability,” said Army Maj. Daniel Yourk, deputy director for operations, VMC. “We are able to move our patients from an inpatient to a home setting with round-the-clock monitoring and reach-back care.”

Through the use of the home kit and self-assessments, healthcare professionals are able to provide continuous monitoring of a patient’s temperature, respiratory rate, heart rate, and oxygen saturation with intermittent monitoring of blood pressure and spirometry, which measures the movement of air into and out of the lungs. They system also enables secure video consultations.

In effect, the program “bridges the continuum of care” from inpatient to outpatient, said Army Lt. Col. Robert Walter, the program’s clinical lead and BAMC’s chief of pulmonary and critical care medicine. “We are offering an additional level of safety, support and monitoring.”

The pilot concept, first developed by the VMC and BAMC, now spans the services and the nation. Participating military medical treatment facilities include Naval Medical Center San Diego, California; Madigan Army Medical Center, Joint Base Lewis-McChord, Washington; Walter Reed National Military Medical Center, Bethesda, Maryland; Mike O’ Callaghan MMC, Nellis Air Force Base, Nevada; David Grant U.S. Air Force Medical Center, Travis AFB, California; Carl R. Darnall AMC, Fort Hood, Texas; and Fort Belvoir Community Hospital, Virginia.

The process starts in the hospital inpatient unit or emergency department prior to discharge and in consultation with designated providers at each military treatment facility. If the patient qualifies for enrollment, they are equipped with the FDA-approved home monitoring kit and detailed verbal and printed instructions. The kit contains a tablet, a network hub that operates independently of Wi-Fi, and an arm band containing a coin-sized monitor. The system also pairs with a blood pressure cuff, a temperature patch and a spirometer. Patients fill out customized questionnaires daily to report how they are feeling. Together, the system enables continuous bio-physiologic and symptom-based monitoring.

Image of woman looking at contents of a home health kit
Kathlyn Chassey uses a home healthcare kit as part of the COVID-19 Remote Monitoring Program, a joint effort of the Virtual Medical Center and Brooke Army Medical Center, in San Antonio, Dec. 16, 2020. (Courtesy photo.)

“Real-time data is compiled into a single dashboard where we can review all patients, grouped by risk,” Walter explained.

A team of teleworking nurses, located in the San Antonio, Texas, area, monitor patients across the eight participating military treatment facilities. Additionally, each site has on-call medical staff in case of an alert or patient concern. Each tablet has a button for assistance that initiates nurse engagement and, if needed, a HIPAA-compliant connection for face-to-face video evaluation with a nurse or on-call physician.

“I felt secure knowing the nurses were keeping an eye on me,” Chassey said. “One night I was having a nightmare. They texted me because my heart rate had increased and wanted to know if I was okay. It’s like being in the hospital, but in the comfort of your own home.”

After a patient no longer needs monitoring or requires a higher level of inpatient care, the patient receives prepaid shipping boxes to pack up the equipment and calls a courier for a contactless pickup. The company then sanitizes, services and repackages the kit for mailing back to the military treatment facility.

The idea for the program was spurred by lessons learned in New York last spring during the initial COVID-19 wave, Walter explained. “The hospitals were so busy; they were having to move patients through the continuum of care, from inpatient to outpatient, at a more rapid pace to accommodate incoming COVID-19 patients.”

Some of these patients were still symptomatic or had higher oxygen requirements, he said, but with new patients flowing in, the care teams were faced with tough decisions. To mitigate risk, some hospital systems established a program in which paramedics would check on patients in their home to ensure they weren’t declining or needing readmission.

“Reflecting on these experiences, we began to explore the idea of leveraging virtual health in the event we are faced with a COVID surge in the hospital and need to move patients more quickly through the facility,” Walter said. “If that happens, it becomes vital to retain capacity without compromising the safety or quality of care for our patients.”

With a global vs. local program in mind, Walter and Yourk approached the Defense Health Agency, which assisted in obtaining and funding 200 home kits that could satisfy the requirement of a “high fidelity of monitoring in an outpatient environment,” Walter said. 

“It is truly incredible how the clinical leads from each military treatment facility and the Virtual Medical Center came together to take this pilot from a concept to reality in under six months to support beneficiaries from the East to West coast,” Yourk added.

With the ongoing threat of the pandemic and to preserve bed capacity, the program is mainly intended for COVID-19 patients at this time, but there is a much broader application potential, Walter noted.

“We are exploring the long-term benefit for a number of conditions that often require frequent admissions, such as congestive heart failure, chronic obstructive pulmonary disease, cystic fibrosis and asthma,” he said. “As with COVID patients, the system can alert us to issues, enabling us the ability to adjust a care plan or facilitate a more rapid assessment if someone’s condition worsens.”

An additional population is patients who come to the Emergency Department who may not meet admission criteria, but could still benefit from elevated care, he added. Further down the line, Yourk hopes the program can be expanded to deployed service members and pediatric patients.

In the meantime, Walter and Yourk are focused on ensuring each military treatment facility has the tools and support needed to successfully carry out this program, particularly as COVID rates increase across the nation. The program will roll out in a phased approach to gauge the efficacy of the system, Walter said, before expanding to additional military treatment facilities.

“We are truly at the leading edge,” he noted. “There are well-validated use cases for single-data monitoring platforms, such as for patients with specific medical conditions such as heart arrhythmia, but we’re helping break ground on a system that can monitor a number of different data points simultaneously for patients with varying diagnoses in the comfort of their home.”

The kits already have been disbursed to participating hospitals and 13 patients were enrolled in the first week, saving approximately 15 bed-days and improving the care delivered to patients, Yourk said.

Chassey said she’s now on the road to recovery, but is thankful for the safety net the remote patient monitoring pilot offered.

“I felt safer going home knowing that I had assistance standing by. I know, from experience, how quickly things can take a bad turn,” she said.

I wish I had something like this before my transplant,” she added. “I spent so much time in the hospital over the years and this type of technology would have given me more time at home.”

Walter said the program is mutually beneficial. “This program enables patients to return home sooner, be with family, while mitigating COVID risks to patients and staff,” he said. “It’s a game-changer for us as we continue to battle this pandemic.”

You also may be interested in...

COVID-19 can lead to long-term health concerns

Article Around MHS
9/23/2021
Debra Lamb, a 30-year civil service veteran at Ft. Carson, contracted the COVID-19 virus late in 2020 and experienced a harrowing ordeal before partially recovering months later.

Debra Lamb, a 30-year civil service veteran at Ft. Carson, contracted the COVID-19 virus late in 2020 and experienced a harrowing ordeal before partially recovering months later.

Recommended Content:

Coronavirus | COVID-19 Vaccine Efforts

DODEA Schools Keeps On With In-Person Classes, and Fall Sports, Too

Article
9/23/2021
Kids playing football

DODEA schools are striving to continue in-person learning in the 2021-22 school year.

Recommended Content:

Children's Health | Coronavirus

6th Medical Group Delivers Mandatory Vaccines

Article Around MHS
9/21/2021
An Airman from the 6th Medical Group prepares a COVID-19 vaccine for distribution at MacDill Air Force Base, Florida.

Airmen from the 6th Medical Group began redistributing doses of the COVID-19 vaccine at MacDill Air Force Base, Florida, on Sept. 9, 2021. This comes after the Secretary of Defense issued a memorandum on Aug. 23, 2021, mandating all active duty personnel to be fully vaccinated against COVID-19.

Recommended Content:

Coronavirus | COVID-19 Vaccine Efforts

Got Your 6

Video
9/16/2021
Got Your 6 Infographic

‘Got Your 6’ is TRICARE’s COVID vaccine video series that delivers important information and updates, on days that end in ‘6.’ It includes the latest information about DOD vaccine distribution, the TRICARE health benefit, and vaccine availability. Got a question about ‘Got Your 6’? Send an email to dha.ncr.comm.mbx.dha-internal-communications@mail.mil

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts

After the ventilator COVID survivor advocates for vaccine

Article Around MHS
9/15/2021
Tim Harris is sedated while on a ventilator

Tim Harris, a mobilization and planning specialist, U.S. Army Medical Center of Excellence, is sedated while on a ventilator at Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, June 27, 2020.

Recommended Content:

Coronavirus

Public Health Prevents Disease in Pods

Article Around MHS
9/13/2021
U.S. Air Force Capt. Spencer Carrier, 86th Operational Medical Readiness Squadron physical therapist, stands in Pod one at Ramstein Air Base, Germany, Sep. 4, 2021. Carrier spends his time outside of work with his church to prepare food for evacuees and their families and also collects donations to pay for clothes, diapers and toys to donate to evacuees in support of Operation Allies Refuge. (U.S. Air Force photo by Airman Jared Lovett)

As part of Operation Allies Refuge, the Public Health team at Ramstein Air Base, Germany, is continuously out in the evacuee camps sharing tips and enforcing regulations to keep Airmen, volunteers and evacuees healthy. By encouraging everyone to wash hands often and wear masks and gloves when appropriate, Public Health works to mitigate the spread of disease and prevent illness.

Recommended Content:

Public Health

Army Medicine Europe Provides Additional COVID Vaccinations for Immune Compromised

Article Around MHS
9/13/2021
Franz Dietrich, a German local national assigned to Training Support Activity Europe, receives a COVID-19 vaccination at the 7th Army Training Command's (7ATC) Rose Barracks, Vilseck, Germany, May 4, 2021. The U.S. Army Health Clinics at Grafenwoehr and Vilseck conducted a "One Community" COVID-19 vaccine drive May 3-7 to provide thousands of appointments to the 7ATC community of Soldiers, spouses, Department of the Army civilians, veterans and local nationals employed by the U.S. Army. (U.S. Army photo by Markus Rauchenberger)

Army medical treatment facilities in Europe are now offering an additional dose of COVID vaccine for immune compromised beneficiaries.

Recommended Content:

Coronavirus | COVID-19 Vaccine Efforts

Food Safety Month: Commissaries Join Other Agencies in Highlighting Foodborne Illness Prevention

Article Around MHS
9/13/2021
FORT CARSON, Colo. — Spc. Crystal Vice, a veterinary food inspection specialist with Public Health Activity Fort Carson, checks the expiration date on a peanut butter container Oct. 13, 2020, at the Fort Carson Commissary. Food inspectors randomly check food and other items before they’re put on the shelves for sale. (Photo by Eric E. Parris)

During Food Safety Education Month in September, DeCA joins the Centers for Disease Control, the U.S. Department of Agriculture-Food Safety Inspection Service, the Department of Health and Human Services and other organizations in reinforcing foodborne illness awareness and prevention.

Recommended Content:

Nutritional Fitness | Public Health

The COVID-19 Pandemic: How Health Care Workers are Coping

Article
9/13/2021
a nurse helping a COVID-19 patient

For health care providers, experiencing the pandemic inside a hospital has brought

Recommended Content:

Coronavirus | Military Health Podcasts

Increased COVID Restrictions on the Pentagon Reservation

Article
9/8/2021
Military personnel wearing a face mask

Due to the increase in COVID-19 cases and positive test cases in the National Capital Region, the Pentagon Reservation will move to Health Protection Condition Bravo Plus (Bravo+)

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus

Digital health innovation emerges during COVID-19 pandemic

Article
8/31/2021
The Defense Health Agency’s Connected Health Branch was there to support, advise and deliver new health innovations throughout the pandemic. (Graphic courtesy of DHA Connected Health)

The DHA's Connected Health Branch was there to support, advise, and deliver new health innovations throughout the pandemic.

Recommended Content:

Connected Health | Coronavirus

As Fitness Tests Resume, Troops Seek Post-COVID Exercise Routines

Article
8/31/2021
Military personnel physically training

Keeping fit during pandemic proves hard for some.

Recommended Content:

Total Body Preventive Health and Total Force Fitness | Total Force Fitness | Physical Fitness | Coronavirus

COVID-19 Booster Shots

Infographic
8/27/2021
If you have an immune system that is moderately to severely compromised, the CDC recommends you may receive an additional dose of mRNA COVID-19 vaccine (Pfizer or Moderna). This would be at least 4 weeks after your second dose.

If you have an immune system that is moderately to severely compromised, the CDC recommends you may receive an additional dose of mRNA COVID-19 vaccine (Pfizer or Moderna). This would be at least 4 weeks after your second dose.

Recommended Content:

COVID-19 Vaccine Toolkit | Vaccine Eligibility | Coronavirus | COVID-19 Vaccine Efforts

Secretary of Defense Mandates COVID-19 Vaccinations for Service Members

Article
8/26/2021
An Army medic administers the COVID-19 vaccine to another soldier.

Secretary of Defense Lloyd J. Austin III yesterday issued a memorandum directing mandatory COVID-19 vaccinations for service members.

Recommended Content:

COVID-19 Vaccine Toolkit | Coronavirus | COVID-19 Vaccine Efforts

DOD Intends to Mandate Pfizer Vaccine, Pentagon Official Says

Article
8/25/2021
Pentagon Press Secretary John F. Kirby holds a press briefing, at the Pentagon, Washington, D.C.

Kirby said the health of DOD's military and civilian employees, families and communities is a top priority.

Recommended Content:

Coronavirus | COVID-19 Vaccine Efforts
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 61

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.