Pediatric Remote Monitoring: Reduced Barriers Enable Action During COVID-19 and Beyond

James Cao, Manager, Children’s Hospitals Initiative, AVIA

The need to contain and prevent community spread of COVID-19 has forced children’s hospitals across the country to severely limit in-person visits at their facilities. Social distancing and shelter-in-place orders have created a new normal of parents working from home while homeschooling and managing their children’s healthcare needs. The pandemic is also leading to increasing percentages of children covered by Medicaid, CHIP, or potentially becoming uninsured, directly impacting children’s hospitals’ bottom lines. This new payer mix, combined with delays or cancellations of elective procedures, will be financially challenging for children’s hospitals for the foreseeable future.

All of these new challenges amplify existing difficulties in protecting the most vulnerable population among us, children with chronic condition(s) or special healthcare needs. These children are members of nearly one-fourth of US households.

Remote monitoring can play a key role during and after the COVID-19 crisis

Remote monitoring is a digital asset that can be invaluable during this unprecedented time. A remote monitoring solution, which can be a combination of a patient/family-facing app, a provider dashboard, and integrated devices or wearables, will enable patients and families to measure and report biometric data, providers to monitor and care for patients more efficiently, and parents to be confident in the health of their child, all while keeping patients and families at home during this pandemic and moving forward.

Children’s hospitals will see immediate benefit from integrating remote monitoring into their care plans during the COVID-19 crisis and ongoing benefit from a long-term investment to improve pediatric chronic care management with remote monitoring.

Dr. Jeff Vergales, pediatric cardiologist and Director of the Remote Monitoring Program at UVA Children’s, stressed the importance of pediatric remote monitoring during COVID-19 and broadly: “We realized in healthcare that we need to raise the standard for treating higher-risk patients at home to match the strides we have made in their in-hospital care. It is essential for healthcare systems to leverage digital solutions utilized by comprehensive clinical teams to get patients out of the hospital sooner, safer and promote their health.”

Regulatory and technological changes lift barriers to adoption

Children’s hospitals can take advantage of new guidelines and opportunities to reduce the financial burdens typically associated with adopting remote monitoring.

  • Section 1135 waivers and State Plan Amendments (SPAs) have decreased regulatory and operational requirements while expanding Medicaid and CHIP coverage and reimbursement.
  • Children’s hospitals can apply for funding for remote monitoring programs from the $200 million Federal Communications Commission Telehealth Program.
  • FCC’s three-year $100M Connected Care Pilot Program will help defray children’s hospitals’ qualifying costs of providing connected care services with a primary focus on benefiting low-income patients.
  • Many remote monitoring vendors are offering unique partnership opportunities in response to the COVID crisis that include discounted or free offerings.

Take steps today to set your hospital up for success

Children’s hospitals should consider the following use cases and operational tactics to optimize their remote monitoring offerings.

  • Use cases
    • Use broadcast text messages to deploy remote monitoring apps for non-COVID diagnosed, COVID-exposed, or high-risk populations that are downloadable on patients’ and families’ devices.
    • Utilize the video visit feature in select remote monitoring apps to enable provider consults.
    • Leverage platform to push out daily alerts for social distancing, handwashing, and additional reminders.
  • Operational tactics
    • Coordinate access for all required medical staff for the remote monitoring app and dashboard.
    • Create file transfer protocols to enable patient data transfer to third-party apps and eliminate short-term need for EMR integration.
    • Set up an escalation tree to triage high-acuity and/or critical patients to the appropriate care team member.
    • Train providers to use the remote monitoring platform as a separate app/web portal to accelerate implementation.

Remote monitoring story from the frontline

Dr. Brooke Vergales, neonatologist and Director of the NICU Remote Monitoring Program at UVA Children’s, described the case of an extremely preterm infant who spent five months in the NICU and was unable to transition to 100% oral feeding, slowing his discharge home. The team discharged him home with the help of a home nasogastric program and the expectation that he would ultimately need a gastrostomy tube. The patient’s parents wanted to give their son a chance to succeed at home before committing to the surgical procedure.

Results surprised both the family and his care team: “On the day of discharge this boy was taking 37% (of his feeds) by mouth. After eight days at home with this family, his nasogastric tube was removed and he continued to take all his feeds by mouth and gain weight appropriately… This little guy is now over a year old and is doing great with his oral skills and has never required any further feeding supplementation.”

To learn more about activating a digital approach to improve pediatrics care or to join us and your children’s hospital peers, check out  our Children’s Hospitals webpage or contact us here.
For more information on leveraging digital to combat COVID-19, explore our COVID-19 Resource Hub on AVIA Connect.

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Join the Children’s Hospitals Initiative

To learn more about activating a digital approach to improve pediatrics care or to join us and your children’s hospital peers, check out our Children’s Hospitals initiative or contact us here.

More COVID-19 Resources

For more information on leveraging digital to combat COVID-19, explore our COVID-19 Resource Hub on AVIA Connect.