Comparative Effectiveness of an Automated Text Messaging Service for Monitoring COVID-19 at Home

While the COVID-19 pandemic has show positive signs in slowing down, providing sudden in-home and hospital care for patients with COVID-19 remains an ongoing struggle. In this study led by PISC Senior Scholar Mucio "Kit" Delgado, MD, MS, and contributed to by postdoctoral fellow Austin Kilaru, MD, and Executive Committee member Zachary F. Meisel, MD, MPH, MA, an intervention called COVID Watch was tested with a total of 3,488 patients. COVID Watch, an automated remote monitoring service for adults with COVID-19 at home, consisted of automated text check-ins twice a day with the option to report worsening symptoms at any time. If a patient reported needing additional assistance, telemedicine clinicians were on hand 24/7 in order to handle such situations. After measuring 30- and 60-day outcomes of patients enrolled and not enrolled in COVID Watch, the study found that COVID Watch patients had 1.8 fewer deaths per 1000 patients at the 30-day outcome and 2.5 fewer deaths per 1000 patients at the 60-day outcome. Among other results, it also found that COVID Watch patients had more telemedicine encounters, emergency department visits, and hospitalizations. Although the researchers acknowledge limitations of unobserved confounding in their study, they conclude that, "Enrollment of outpatients with COVID-19 in an automated remote monitoring service was associated with reduced mortality, potentially explained by more frequent telemedicine encounters and more frequent and earlier presentation to the ED."

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