The rising number of COVID-19 cases have now exceeded hospital capacity, causing an increase in admission waiting time and difficulties in patient care. An alternative to traditional hospital care is home care. Unfortunately, it is difficult to administer, as it does not allow normal procedures, such as data recording, follow-up, and data input, to be performed as effectively as the traditional form of care in which practitioners can conveniently provide a close examination and record patient data. This has posed a challenge to traditional healthcare practices and the incorporation of IT technology to overcome such difficulties is urgently needed.
Assist. Prof. Dr. Worawit Janchai, dean of the College of Arts, Media and Technology (CAMT), Chiang Mai University, revealed that he was contacted by a team of doctors at Phramongkutklao Hospital to consult on a project to develop a home isolation system. So, he gathered the staff working on medical informatics to come up with such a system as quickly as possible, as the number of cases had already exceeded the hospital capacity. Assist. Prof. Dr. Orawit Thinnukool, head of the research group on embedded operating systems and mobile applications for health science at CMU, partnered with BAAK Co., Ltd., a CMU start-up jointly owned by Angkaew Holding and Banana, a famous IT company specializing in creating back-office for marathon events. The company provided services related to tailoring health platform solutions to patient care functions to organisations both within and outside the university.
Before the implementation of this newly-developed home isolation system, Phramongkutklao Hospital discovered that most patients, who were elderly or had underlying conditions, could not use social media, so there needed to be an easily accessible platform that did not require any additional steps. At first, the LINE application was used as the main platform, while data recording and check-ups were done on Google Forms and Google Sheets. Despite regular system updates, it was found that the data stored in the Google platforms were slow to process and there were instability issues, due to the increasing number of patients. Moreover, the system’s structure could not accommodate the patient care practice outside the setting. These problems gave rise to this home isolation system, co-developed by the team at Phramongkutklao Hospital, led by Lt. Col. Wasin Wasikasin, M.D., Maj. Natchaphon Nopphakro, M.D., Chantima Traiphaathanakun, M.D., and the team from CMU
The framework of the project ‘Centre for COVID-19 Patient Care Coordination’ by Phramongkutklao Hospital is home isolation. However, instead of admitting patients with mild symptoms following the general principles of home isolation, this system oversees patients with mild to moderate symptoms with a high chance of aggravation in order to minimise the chance of developing severe symptoms. The hospital will take care of all patients under its responsibility, even those who test positive at other healthcare institutions. The only criteria is that the patients do not have hypoxia and/or hemodialysis history. Once admitted, the patients will get a chest x-ray on the first day and be prescribed favipiravir if pneumonia is found or there is a risk of it developing, and they will be treated with corticosteroids when hypoxia starts. Moreover, the patients will have three meals delivered to their place every day and their conditions will be monitored at least twice daily via the LINE application, using the data obtained by the provided thermometer kit and fingertip pulse oximeter.
It took only two weeks to develop the system and link it to the existing medical record system and now, the system has already been implemented at the Centre for COVID-19 Patient Care Coordination. It is easy to use, and allows the patients to access preliminary care and get an effective assessment of their conditions. It also helps enhance coordination between doctors and nurses so that any changing conditions can be readily observed. Furthermore, the fact that it is linked to the hospital’s record system leads to more accurate operation, as well as reduced paperwork and workforce required to fulfil the coordinating responsibility, thus allowing more practitioners to be allocated to patient care. At present, the team from CMU has also developed a bed booking system for efficient bed management that helps support the government’s home isolation policy and the preparation for future waves of infection.