188 - Evaluation of a Remote Patient Monitoring Program for Young Children with Respiratory Illness

Publication Number: 4185.188

Meghan Cain, Mayo Clinic Children's, Rochester, MN, United States; Alexa Jensen, Mayo Clinic Children's Center, Rochester, MN, United States; Fogelson C.. Elizabeth, Mayo Clinic Alix School of Medicine, Rochester, MN, United States; David Hall, Mayo Clinic Children's Center, Rochester, MN, United States

Background: Pediatric patients with respiratory illnesses such as bronchiolitis often present multiple times for medical visits, leading to stress on families and care facilities. Despite return instructions, caregivers may continue to be uncertain about when re-evaluation is necessary, especially when their child has dynamic clinical symptoms. Our institution developed a Remote Patient Monitoring (RPM) program with the goal of supporting caregivers and more accurately identifying patients who do require repeat evaluation.

Objective: This study aimed to evaluate the feasibility and clinical impact of a novel RPM program for young children with respiratory illness.

Design/Methods: This is a retrospective observational cohort study of pediatric patients evaluated for respiratory illness during a 17-month period. Patients aged 6-36 months being discharged from clinic, emergency department (ED) or hospital visits were eligible for enrollment. At the index visit, families received a kit for collecting vital signs which were submitted electronically along with a symptom questionnaire 3 times per day. If the data submitted was outside defined parameters, the RPM nursing team contacted the caregiver to review and determine the appropriate next steps in care. Once the illness episode was resolved, patients graduated from the RPM program.

Results: During the study, 51 patients were enrolled in the program. Ten patients did not actively participate in the program, with no response from family as the most common reason for dropping out. Forty-one patients completed the program with 32 enrollments (78.1%) from the ED, 8 from clinic (19.5 %) and 1 at hospital discharge (2.4%). Of the 41 program participants, the median age was 13 months (IQR: 8-18.5) and 23 (56.1%) were male. The median enrollment duration was 8 days (IQR: 6-9) from index visit to program completion. While enrolled in the program, 29 patients (70.7%) connected with the RPM nurses due to symptom or vital sign alert, with 7 (17.1%) families contacting the standard nurse triage line. Eighteen (43.9%) patients were evaluated in-person, accounting for a total of 14 ED and 9 clinic visits. Six (14.6%) patients were admitted to the hospital during their illness, all of whom were cared for on the general floor and discharged without complication.

Conclusion(s): This RPM program allowed families to stay connected to the medical team, facilitating ongoing evaluation of their child’s clinical status from home. Further investigation is required to understand and optimize its impact on patients, families and medical facilities.