Portable health clinic COVID-19 system for remote patient follow-up ensuring clinical safety

Rafiqul Islam , Fumihiko Yokota , Mariko Nishikitani , Kimiyo Kikuchi , Yoko Sato , Rieko Izukura , Md.Mahmudur Rahman , Md.Rajib Chowdhury , Ashir Ahmed , Naoki Nakashima
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Abstract

Background

A developing country like Bangladesh suffers very much from the sudden appearance of the COVID-19 pandemic due to the shortage of medical facilities for testing and follow-up treatment. The Portable Health Clinic (PHC) system has developed the COVID-19 module with a triage system for the detection of COVID-19 suspects and the follow-up of the home quarantined COVID-19 patients to reduce the workload of the limited medical facilities.

Methods

The PHC COVID-19 system maintains a questionnaire-based triage function using the experience of the Japanese practice of diseases management for early detection of suspected COVID-19 patients who may need a confirmation test. Then only the highly suspected patients go for testing preventing the unnecessary crowd from the confirmation PCR test centers and hospitals. Like the basic PHC system, it also has the features for patients’ treatment and follow-up for the home quarantined COVID-19 positive and suspect patients using a telemedicine system. This COVID-19 system service box contains 4 self-checking medical sensors, namely, (1) thermometer, (2) pulse oximeter, (3) blood pressure machine, and (4) glucometer for patient's health monitoring including a tablet PC installed with COVID-19 system application for communication between patient and doctor for tele-consultancy.

Results

This study conducted a COVID-19 triage among 300 villagers and identified 220 green, 45 light-yellow, 2 yellow, 30 orange, and 3 red patients. Besides the 3 red patients, the call center doctors also referred another 13 patients out of the 30 orange patients to health facilities for PCR tests as suspect COVID-19 positive, and to go under their follow-up. Out of these (3 + 13 =) 16 patients, only 4 went for PCR test and 3 of them had been tested positive. The remaining orange, yellow and light-yellow patients were advised home quarantine under the follow-up of the PHC health workers and got cured in 1–2 weeks.

Conclusions

This system can contribute to the community healthcare system by ensuring quality service to the suspected and 80% or more tested COVID-19 positive patients who are usually in the moderate or mild state and do not need to be hospitalized. The PHC COVID-19 system provides services maintaining social distance for preventing infection and ensuring clinical safety for both the patients and the health workers.

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便携式卫生诊所COVID-19系统,确保患者远程随访,确保临床安全
由于缺乏用于检测和后续治疗的医疗设施,像孟加拉国这样的发展中国家在COVID-19大流行的突然出现中遭受了很大的打击。移动诊所系统开发了带有分诊系统的COVID-19模块,用于发现COVID-19疑似病例和对家中隔离的COVID-19患者进行随访,以减少有限的医疗设施的工作量。方法PHC COVID-19系统采用基于问卷的分诊功能,借鉴日本疾病管理实践经验,早期发现可能需要进行确诊检测的疑似COVID-19患者。这样一来,只有高度疑似患者才会去检测,从而避免不必要的人群涌向确诊性PCR检测中心和医院。与基本的PHC系统一样,它还具有使用远程医疗系统对家庭隔离的COVID-19阳性和疑似患者进行患者治疗和随访的功能。该新型冠状病毒感染系统服务箱包含4个自检医疗传感器,分别是(1)体温计、(2)脉搏血氧仪、(3)血压仪、(4)血糖仪,用于监测患者的健康状况。其中包括一台安装新型冠状病毒感染系统应用程序的平板电脑,用于患者与医生之间的远程咨询。结果本研究对300名村民进行了COVID-19分类,发现绿色220例,浅黄色45例,黄色2例,橙色30例,红色3例。除了3名红色患者外,呼叫中心的医生还将30名橙色患者中的13名患者作为新冠病毒疑似感染者,转到保健所进行了后续治疗。在这(3 + 13 =)16例患者中,只有4例进行了PCR检测,其中3例检测呈阳性。其余橙色、黄色和浅黄色患者在基层卫生工作者随访下居家隔离,1-2周治愈。结论该系统可为疑似和80%以上的新冠肺炎阳性患者提供优质服务,这些患者通常处于中、轻度状态,无需住院治疗。初级保健中心COVID-19系统为预防感染和确保患者和卫生工作者的临床安全提供保持社会距离的服务。
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