Enhanced Monitoring System to Better Monitor High-Risk COVID-19 Patients.

ABSTRACT

Telemedicine (TM) is a useful tool to extend medical care during a pandemic. TM was extensively utilized in Singapore during the COVID-19 pandemic as part of the Nation's COVID-19 healthcare strategy. Patients were risk stratified to prioritize limited healthcare resources and the Telemedicine Allocation Reconciliation System (TMARS) was adapted to monitor and manage limited TM resources. High-Risk patients (Protocol 1) had an escalation rate of 4.87%, compared to the non-High-Risk patients' 0.002% and TM doctors spent an average of six hours to complete one tele-consultation. In order to optimize the efficiency of the TM system, an enhanced monitoring system was implemented in March 2022. The intent was to focus monitoring efforts on the High-Risk patients. High-Risk patients reporting sick for the first time were prioritized to receive tele-consultations through this system. With the aid of a data-driven dashboard, the Operations Control and Monitoring team (OCM) was able to closely monitor the performance of the various TM providers (TMPs), sent them timely reminders and re-assigned patients to other TMPs when the requisite turnaround time was not met. Implementing the enhanced monitoring system resulted in a significant reduction in the average time taken to provide tele-consultations. After 3 months of implementation, the percentages of consultations completed within two hours were raised from 75.7% (February 2022) to 96.8% (May 2022), greatly increasing productivity and efficiency.