The European Respiratory Society (EFS) held their ERS International Congress 2020 where Philips https://www.philips.com presented a clinical symposium specifically on the evolving role of telemedicine in initiating home Non-Invasive Ventilation (NIV) for COVID patients.
Dr. Marieke Duiverman, Department of Pulmonary Diseases/Home Mechanical Ventilation, at the University Medical Center Groningen, in the Netherlands, discussed how research has been conducted around the use of telemedicine when using NIV in stable hypercapnic COPD patients. She discussed the implications for both patients and providers, as well as for the overall healthcare system.
She discussed how home NIV has evolved significantly, especially when compared with standard care. She suggests that providers look at the organization of their teams to ensure that they can adequately administer remote care and monitoring. Most likely, more nurses will be needed and will need additional training.
There are several considerations when implementing telemedicine and home NIV initiation such as:
- Platforms and Technology—Today, it is still necessary to log in to multiple platforms to monitor devices and patient data. It is necessary for clinicians to be careful in logging in as they manage patients who may be on different ventilator systems
- Privacy and Security—Since much of the patient’s data is sent over the Internet, it is important to have the right technology and partners in place to guarantee that the patient’s data is kept private and transferred in a secure manner
- Technical and Digital Adeptness/Comfort—It is important that the patient has some basic understanding of the technology being used or is at least comfortable using the technology and devices
- Selecting Patients—Patients receiving home NIV initiations need to be evaluated individually as to their environment, level of tech skills and mobility, as well as whether they will be supported by a caregiver
Dr. Duiverman explained, “Before the studies began, we assumed that home ventilation for COPD patients was impossible due to their need for higher pressures and more frequent pressure adjustments. However, we found that it was not only possible, but s when home NIA was used, it was found to be effective and less expensive.