#FightCOVID19 : how to improve patient follow-up?

We continue our #FightCOVID19 series, with a focus today on the patient enrollment process.

Nathan Veyret
March 24, 2020

We continue our #FightCOVID19 series, in which we describe daily the progress of our patient monitoring platform project. Focus today on the patient enrollment process.

As you know, our hospitals are facing a large influx of patients in recent days. It is becoming difficult for them to keep patients with COVID-19, who do not have severe symptoms in the majority of cases. Keeping them in hospital therefore has two negative consequences: a limitation of places for the most serious patients, and a risk of contamination of the healthcare staff.

The platform therefore enables patients to be sent home while ensuring regular follow-up. It is indeed important to maintain daily contact with the patient, as many cases present a worsening of symptoms after 5 to 8 days.

Today, patients are classified on the platform according to four categories, which evolve according to the answers provided by the patient through a form that he/she is asked to fill out daily.

  • "Green" patients are asymptomatic and have no quarantine problems, so no action by the medical team is required. Automatic messages are sent to reassure patients and remind them to continue to complete the regular forms.

  • "Yellow" patients are stable and show no signs of severity, so no action by the medical team is required. Automatic messages are sent to reassure patients and remind them to continue to complete the regular forms

  • "Orange" patients are those whose symptoms have recently changed and may require closer monitoring. When a patient is marked "orange", the frequency of questionnaires is increased. In addition, action is required from the medical team.

  • "Red" patients are those with rapidly changing symptoms, signs of severity or quarantine problems. Rapid action is required by the medical team.
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How are patients added to the platform?

When the monitoring team is connected to the platform interface, they can click on "Add new patient". At this point, they are prompted to fill out a form containing a set of fields to be filled in to track the evolution of the virus, based on demographic factors or medical history.

These answers also facilitate the follow-up and management of the patient.

The healthcare monitoring team also adds the patient's treating physician through a French directory of healthcare professionals maintained by Lifen, in order to ensure coordination between family doctors and hospitals. The attending physician is then notified of the beginning of the follow-up.

Once the Patient record has been created, follow-up is triggered by clicking on "Send a form", which will then send an SMS to the patient concerned.

A full description of the questionnaire is presented in this video :

What's the patient view today?

When the follow-up has started, the patient receives a first information SMS, notifying him/her of the start of the follow-up and of the daily sending of follow-up forms.

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Thereafter, the patient receives a daily link by SMS, giving him access to a questionnaire on his mobile browser, where he/she is asked to fill in a set of measures to identify the severity of his symptoms.

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Throughout the questionnaire, advices are given to refer the patient when measurements are taken (breathing rate, etc...).

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How can we ensure that patients fill out this information?

During their follow-up, patients agree to provide daily feedback through questionnaires to the care teams in charge of the follow-up.When patient does not respond to the questionnaire, the follow-up teams have the possibility to remind the patient by SMS, directly from the platform.

You will find below a demonstration of the evolution of the monitoring of a patient and the actions to be carried out consequently on the monitoring platform.

You want to deploy the platform? Are you a Ruby, React or React-native developer and you want to join the fight against COVID-19? We would be delighted to support you so contact us at covid19@lifen.fr!

At Lifen, our mission is to facilitate the coordination of care between hospitals, family doctors and patients. We manage more than one million medical reports each month from 80.000 physicians.

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