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

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

Image of two medical personnel, wearing masks, looking at the contents of a home-based COVID treatment kit. Click to open a larger version of the image. Click to open a larger version of the image. 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 | | Nursing in the Military Health System

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...

Army Public Health Nurse offers thank you to nurses across Army: Reminder of where we came from

Article Around MHS
5/9/2022
Military personnel on infographic

U.S. Army Public Health Center thanks all Army Public Health Nurses for the hard work and dedication you show to the communities you serve every day. 

Recommended Content:

Nursing in the Military Health System | Nurses Week Toolkit: United In Service, Rooted in Strength

Latasha Smith: Warrior against COVID-19

Article Around MHS
2/18/2022
Military personnel looking at a patient's cardiac rhythm

Air Force Tech. Sgt. Latasha Smith, an Airman assigned to the 86th Operational Medical Readiness Squadron, was celebrated as Airlifter of the Week, Jan. 27, 2022, after leading the assault against COVID-19 for over a year.

Recommended Content:

Coronavirus

COVID-19 therapeutics support DOD pandemic response

Article Around MHS
2/11/2022
Military personnel getting COVID-29 doses ready

The U.S. Army Medical Materiel Agency is helping to protect the operational force by distributing several new therapeutic options that help to lessen the symptoms of mild-to-moderate cases of COVID-19 and keep Soldiers, their families and beneficiaries out of the hospital.

Recommended Content:

Coronavirus

COVID-19 Health Action Response for Marines continues to study long-term effects of COVID-19 on Marines

Article Around MHS
2/10/2022
Medical military personnel talking to a patient

A team composed of U.S. Navy medical personnel and civilian technicians based out of the Naval Medical Research Center in Silver Spring, Maryland, assembled during the initial outbreak of COVID-19 to study the short and long-term effects that the virus has on Marines. 

Recommended Content:

Coronavirus

Getting up-to-date on your COVID-19 vaccine

Article Around MHS
2/8/2022
Military personnel giving the COVID-19 vaccine

The U.S. Guard Coast is that we have vaccines to help prevent serious illness if you contract COVID-19.

Recommended Content:

Coronavirus

Oregon National Guard surging to support hospitals again

Article Around MHS
1/27/2022
Oregon Army National Guard touring a hospital

Hundreds of Oregon National Guard members are increasing support of hospitals throughout the state in their second hospital relief mission during the COVID-19 pandemic.

Recommended Content:

Coronavirus | Readiness Capabilities

Public Health nurses offer insights on living with COVID-19 now, looking into future

Article Around MHS
1/25/2022
The Challenges of Living with COVID

One of the more challenging jobs for any public health professional is dealing with unpredictability inherent in outbreaks like the current COVID-19 pandemic.

Recommended Content:

Coronavirus

Navy Hospital Corpsman steps into the breach in the war on COVID-19

Article Around MHS
1/18/2022
Hospitalman Hector Conde standing in front of a immunization office's refrigeration

First responders and those fighting on the medical battleground have earned well-deserved recognition for their efforts.

Recommended Content:

Coronavirus

This is my Why

Article Around MHS
12/30/2021
Air Force Senior Airman Marcus Bullock poses for a photo after receiving his COVID-19 vaccination

Air Force Senior Airman Marcus Bullock stated his reason for getting the vaccine was to help his mother and son be able to have a play date again.

Recommended Content:

COVID-19 Vaccine Efforts | Coronavirus

So others may breathe - Navy Medicine Respiratory Therapist cares for COVID casualties

Article Around MHS
12/13/2021
Military Health personnel posing for a picture

Navy Hospital Corpsman 2nd Class Tessa Hazard, a respiratory therapist, recently deployed to Alabama as a member of a COVID-19 response team.

Recommended Content:

Coronavirus

Army Public Health Center provides update on Long COVID risks

Article Around MHS
12/1/2021
COVID19 Symptoms

According to the Centers for Disease Control and Prevention, Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19.

Recommended Content:

Coronavirus

JTF Coyote begins pediatric COVID-19 clinics as adult booster vaccination numbers increase

Article Around MHS
11/23/2021
Military health personnel giving the COVID-19 vaccine

The Vermont National Guard now supports the state's response to the COVID-19 pandemic with vaccinations for youth in the 5 to 11 age group and booster clinics for the general adult population.

Recommended Content:

COVID-19 Vaccine Efforts | Coronavirus

USECAF receives insight into COVID19 vaccinations at Reserve wing

Article Around MHS
10/8/2021
Under Secretary of the Air Force Gina Ortiz Jones visits with 433rd Airlift Wing members at Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, Texas, Oct. 2, 2021.

Under Secretary of the Air Force Gina Ortiz Jones visited the 433rd Airlift Wing here to meet with Reserve Citizen Airmen leaders on mandatory COVID-19 vaccination efforts, Oct. 2, 2021.

Recommended Content:

COVID-19 Vaccine Efforts | Coronavirus

Compassionate Caring with COVID Vax Commitment

Article Around MHS
10/6/2021
A  female doctor poses for a photo.

When pregnant patients have an appointment with Lt. Cmdr. Megan Northup at Naval Hospital Bremerton, they get more than a qualified and caring OB/GYN physician.

Recommended Content:

Coronavirus | COVID-19 Vaccine Efforts

Health Promotion duo optimizes health on Incirlik Air Base

Article Around MHS
9/30/2021
Air Force Capt. Sydney Sloan, 39th Operational Medical Readiness Squadron health promotion element chief (right), and Air Force Senior Airman Gloriann Manapsal, 39th Operational Medical Readiness Squadron health promotion technician (left), promote making healthy choices at the Sultan’s Inn Dining Facility on Incirlik Air Base, Turkey.

The 39th Operation Medical Readiness Squadron health promotion team provides and integrates evidence-based programs to optimize the health and readiness, even during these unprecedented times.

Recommended Content:

Health Readiness | Total Force Fitness | Coronavirus
<< < 1 2 > >> 
Showing results 1 - 15 Page 1 of 2

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.