Outcomes of a home telemonitoring program for SARS-CoV-2 viral infection at a large academic medical center

INTRODUCTION

Telemedicine serves as a viable option during the COVID-19 pandemic to provide in-home care, maintain home isolation precautions, reduce unnecessary healthcare exposures, and de-burden hospitals.

METHODS

We created a novel telemedicine program to closely monitor patients infected with SARS-CoV-2 (COVID-19) at home. Adult patients with COVID-19 were enrolled in the program at the time of documented infection. Patients were followed by a team of providers via telephone or video visits at frequent intervals until resolution of their acute illness. Additionally, patients were stratified into high-risk and low-risk categories based on demographics and underlying comorbidities. The primary outcome was hospitalization after enrollment in the home monitoring program, including 30 days after discharge from the program.

RESULTS

Over a 3.5-month period, 1128 patients met criteria for enrollment in the home monitoring program. 30.7% were risk stratified as high risk for poor outcomes based on their comorbidities and age. Of the 1128 patients, 6.2% required hospitalization and 1.2% required ICU admission during the outcome period. Hospitalization was more frequent in patients identified as high risk (14.2% vs 2.7%, P < 0.001).

DISCUSSION

Enrollment in a home monitoring program appears to be an effective and sustainable modality for the ambulatory management of COVID-19.

Diamond burr otoplasty

We present a technique for the treatment of prominent ears using a diamond burr to produce a very natural and stable antihelical fold. Our experience in the treatment of over 43 ears over a ten-year period has been very satisfactory for both patient and surgeon. This procedure overcomes many of the shortcomings of more traditional techniques of otoplasty, including suture pull-through, widened antihelical fold, and an unpredictable, unstable result.