Patients with a mild form of COVID-19 can only stay isolated at home and call a doctor if their condition worsens. But what sounds like a sensible requirement to avoid overloading hospitals quickly turns out to be problematic if patients either don’t strictly monitor their own condition or simply misjudge it.
Older Patients Often Misjudge Their Condition
"Among elderly patients, this is not uncommon, it has been seen in Italy: everyone held off until too late, and then tried to get into [the hospital in] the morning if their conditions worsened at night", cardiologist Georg Schmidt explained. "And then it was often too late, because they arrived at the hospital in poor condition with little chance of survival".
Dr Schmidt is not only a cardiologist, but also head of the Biosignal Processing Group at the Rechts an der Isar clinic at the Technical University of Munich. For about 20 years he has been studying the remote monitoring of cardiac patients. He describes as "pure coincidence" the fact that his technology turned out to be quite useful during the current coronavirus pandemic. It is also a fortunate coincidence that the clinic, together with the Munich Health Department, is planning to conduct a study to help solve problems with quarantine patients via sensors and telemedicine.
Sensor in the Ear to Take Control
An earplug-like sensor attached to the ear is designed to prevent unnecessary deterioration in a person's health. Every 15 minutes it measures the vital functions of the patient’s body, including body temperature, heart rate, respiratory rate, and blood saturation. Another parameter, the so-called Polyscore, is measured four times a day. It records the "internal regulatory mechanisms of the body" or, more simply, "the organism’s reserves to fight the disease".
According to Schmidt, all the data that a doctor needs to know to make a decision is collected at home.
"We bring the monitor, which is usually located in the continuous monitoring unit, into patients’ homes, and we don’t need any huge infrastructure changes", the cardiologist said.
The sensor sends the data to a transmitter via Bluetooth, which then forwards it to a hospital server via a telephone connection.
"We’ve set up a special telecentre at the Technical University to remotely monitor the coronavirus, with four teams that monitor the data 24 hours a day, seven days a week", Schmidt explained. "Of course, we don’t leave the patient at the mercy of the machine, our employees can always see the signal on the screen".
Ambulance Arrives When There's a Red Signal
The patient’s overall condition is expressed using the three colours of traffic lights: "When there's a red signal, the ambulance arrives immediately, since we have the digital parameters that doctors need to make a decision", Schmidt explained. According to him, if the signal is yellow, an appropriate doctor should call the patient to find out how they feel, and schedule an examination if necessary. If the signal is green, the patient is informed by telephone that their condition is likely to be good, and asked about their health.
First, a two-month study will involve 1,200 patients, divided into three categories: those over 60 years old, people who've tested positive for SARS-CoV-2, and those quarantined at home. Additionally, this is the first time that a large-scale test of telemedicine's capabilities will be carried out.
"This will give a powerful impetus to telemedicine as a whole, because then it will become clear what advantages it has", Schmidt believes.
In his view, such tools are also important for patients who are currently avoiding hospitals for fear of infection, although important examinations are pending.
"As a cardiologist, I can tell you about defibrillator or pacemaker patients who don’t dare to come to the clinic for a check-up", the cardiologist pointed out.
Telemedicine makes it possible to collect important information about the patient’s health status and hold remote consultations. According to Schmidt, if the indicators are good, the patient gets a sense of security; if there are problems, the patient will be urgently taken to the clinic.
What About Personal Data?
There are currently some doubts regarding the security of coronavirus patients’ personal data. What does Munich Technical University think about this?
"Our system is absolutely secure; the data is anonymised, and the server is also in a secure environment", Schmidt said, adding that he "has conflicting feelings", regarding the personal data protection issue.
"Data protection is important. In each case, one has to weigh the pros and cons: whether it’s possible to abandon certain protective mechanisms in case of such a threat in order to be able to better resist the disease. But it’s also necessary to ensure that these regulatory mechanisms can be turned off when the threat subsides".
