For families around the world, the coronavirus has posed a series of new challenges. How do we stay safe? What do we do if we catch it? When should I go to the hospital?
To help answer these and other questions, Scripps Health established the COVID Care Companion program. Part of Scripps’ new focus on remote patient monitoring, the complimentary program offers regular clinical monitoring for Scripps patients who have tested positive for COVID-19. The goal is to help them cope with the disease and — as long as it’s safe to do so — keep them from being admitted or readmitted to the hospital due to COVID-19.
The program has been an enormous success. As of mid-September 2020, more than 1,000 patients were enrolled and 635 graduated. But that’s just the beginning. The lessons learned from the COVID Care Companion program will be used to help many other patients throughout San Diego County.
“COVID-19 has catapulted our efforts toward more remote patient monitoring,” says program lead Tracy Chu, vice president, Scripps Medical Foundation. “It’s allowing us to have a remote digital connection with our patients to improve their care. Our plan for the upcoming year is to roll out these services to a broader population, focusing on people with diabetes, heart failure, COPD and other chronic conditions.”
The COVID Care Companion Program was created to give patients better tools to self-quarantine successfully. It begins when nurses reach out to patients at home who have tested positive to enroll them in the program. Participants can either use their MyScripps app or receive daily phone calls, whichever is more convenient.
“We want to check their vitals on a daily basis,” says Mora Cannon, RN, a COVID Care Companion nurse. “We want to know their temperature and heart rate, whether they are weak or short of breath or coughing or vomiting. Are they better, worse or the same as the previous day?”
If a patient’s condition can no longer be managed at home, a nurse will first encourage them to go to the emergency room, then will alert the staff that the patient is coming to further streamline care.
“It’s a proactive connection point,” Chu says. “Our nurses can really get in front of a lot of issues.”
“I could have called with a variety of questions and concerns, including to say that my husband was having shortness of breath, and they would have advised us what to do.”Cherie Eyer
The program also helps nurses allay patient fears. Given the drumbeat of bad news about the virus, some equate a COVID-19 diagnosis with certain hospitalization.
“We’ve had quite a few patients ask: ‘When am I going to end up in the hospital?’” Cannon says. “It’s important to dispel that misinformation so people can feel safer.”
The program has been a lifeline for hundreds of COVID-19 patients who have been in self-quarantine. Cherie and Larry Eyer live in El Centro and also have a home in San Diego. Though they had relatively mild infections, they needed guidance to help them cope with the many unknowns.
“After we tested positive, Scripps contacted us and told us about the isolation procedures,” Cherie says. “They set us up with a mobile app to monitor our vitals. We didn’t even have a thermometer, so we purchased a digital thermometer, a blood pressure meter, a blood oxygen meter, and we started monitoring twice a day. If we forgot to put the information in the app, we’d get a friendly wellness check phone call.”
And the communications went both ways. With a new disease like COVID-19, it’s hard to know how to respond if symptoms worsen.
“We had this great number to call; I still have the sticky note on my microwave,” Cherie says. “I could have called with a variety of questions and concerns, including to say that my husband was having shortness of breath, and they would have advised us what to do.”
Cherie is also grateful that the care companion team helped her select a Scripps primary care physician for continued care.
San Diego residents Kat and Jason faced a more acute situation. They and their two small children all had COVID-19, forcing the adults to be patients and caregivers simultaneously. The family experienced the typical symptoms: fever, fatigue, aches, coughing, sneezing. Some days they thought they were recovering, but the next day they would be worse. The family’s COVID Care Companion nurse helped guide them through these ups and downs and secure needed appointments.
“It was great for us to have a place to call and ask questions,” Kat says. “We needed appointments, so we called the nurses and they said, ‘Don’t worry, we’re going to expedite this.’ They called us back and said, ‘These are the times, this is your appointment.’”
One of the most difficult aspects of contracting COVID-19 is the quarantine. Many patients feel like they are in solitary confinement and, in some cases, rely on their COVID Care Companion nurse as their most important point of contact with the outside world. To these patients, getting those regular phone calls from Scripps nurses has been a lifeline.
“There was this tremendous sense of loneliness because we were quarantined in our home and just trying to survive this thing,” Jason says. “The one source of consistency and positivity was the Scripps team. It reminded us there are people who are firmly in our corner and are trying to help us get better. It just felt great during a very dark moment.”
The COVID Care Companion Program is reaffirming what many at Scripps had already known: Consistent remote contact between patients and providers improves care and keeps people healthier.
“One of the things we’ve learned from the COVID Care Companion program is the importance of patients having easy and accessible ways to contact nurses and other providers,” says Chu. “Often, they just need someone to touch base with them on a more frequent basis to make sure they’re staying focused on their condition.”
Scripps alternates between digital connections, such as messages through the MyScripps app, with phone calls and other approaches to maintain a consistent dialogue between patients and providers. Patients enter key health metrics into the app and regularly chat with their nurse. When patients have questions or need to set up an appointment, they have a specific person they can call — someone who knows their history and can help them navigate the system. These ongoing communications help spot health troubles early, when they are more easily remedied.
“We want to keep people at the lowest risk level possible,” Chu says, “and help them manage their disease so they can live their fullest possible lives. We want to ensure patients get the appropriate care at the right time. So, instead of waiting for their condition to flare up, we can modify their care at home and, hopefully, keep them out of the hospital.”