In March 2020, healthcare providers nationwide shifted to a singular focus: the COVID-19 pandemic. Most elective surgeries halted in the United States within a matter of weeks.1 Hospitals, clinics, and even certain public spaces — such as the Javits Convention Center in New York City2 — were transformed into care facilities dedicated to treating people with this highly-contagious coronavirus.
Hospitals and other healthcare organizations enacted disaster plans, changing a once dynamic system into a singular entity with a common goal. Elective surgeries were deemed non-essential and telehealth became more commonplace.1 It wasn’t until May 2020 that organizations slowly began elective surgeries again, and that was highly dependent on local infection rates, staff availability, and surgical urgency.3
Unparalleled challenges of elective surgery backlogs
As the pandemic continues, the backlog of elective surgeries is increasingly problematic. During the 12 weeks of peak disruption due to COVID‐19, an estimated 28 million surgeries were cancelled or postponed worldwide.4
A stockpile of uncompleted or delayed procedures is often referred to as “care debt.” The “care debt” that hospitals across the country still face is massive: Estimates show more than 1 million cases backlogged in the United States in orthopedic surgery alone,5 and it will take 7, 12, and 16 months — in optimistic, ambivalent, and pessimistic scenarios, respectively — until 90% of the pre-pandemic forecasted surgery volume is complete.6
The problem with the backlog of elective surgeries is the potential consequence of delay. A knee replacement might typically be scheduled a month out, but now due to backlogs, it is scheduled three months out. Depending on a variety of scenarios, a patient’s condition can worsen while stuck in a holding pattern.
Similarly, a non-emergent case can turn into an emergent or urgent one if delayed too long.
Prehabilitation and remote patient monitoring
Prompt, personalized care is associated with better health outcomes, but this can be challenging during crisis situations such as the COVID-19 pandemic.8 Remote patient monitoring is a useful tool for helping providers monitor patients on waitlists for surgeries.
Remote patient monitoring offers providers a regular stream of data designed to allow keen insight on a patient’s condition while in the prehabilitation phase. This potentially eliminates episodic office visits so a patient can safely shelter in place, limiting the spread of infectious disease.9
Remote patient monitoring provides data that informs providers, which aids in making decisions about appropriate steps to help get the patient in optimum preop condition. The healthier a patient is, the less likely they’ll have surgical complications. This supports better outcomes and lower associated costs.9,10
Additionally, remote patient monitoring provides condition-related information so providers can promptly respond if a patient’s condition worsens. For example, if the data shows trend departures, providers are alerted and can determine which interventions to take, including surgical prioritization.
Remote patient monitoring can be customized to specific patients or patient populations to best inform providers while strategically educating the individual. This personalized monitoring can be helpful before surgery as well as during recovery and rehabilitation to support optimal care any time the patient is away from a care facility.
For a joint replacement patient, a provider could request an image of their incision or daily weigh-ins as well as blood pressure and oxygen saturation readings. Having the patient wear a smart active brace can gather range-of-motion data. Patient pain ratings and medication tracking can help monitor quality of life.
Remote patient monitoring also benefits the patient through education, helping them take an active role in their healthcare journey.9 They are made aware of what the program is monitoring and can learn how to manage their conditions as they interact with the technology. If an alert occurs, the patient learns why it happened and the appropriate next steps.
This patient engagement provides a connection to their healthcare team on a level they may have never experienced before. They may feel more confident their condition is being monitored and they have a platform to ask questions and receive timely feedback. This helps position the patient for success throughout the care continuum.10
Customizable solutions for an evolving world
At the start of the COVID-19 pandemic, many elective procedures were cancelled or delayed.1 These have caused a “care debt,” which must be managed through thoughtful resource allocation while keeping infectious disease concerns top of mind.4 Virtual care solutions help providers effectively monitor patients while keeping them engaged in their care at home.9 With a long history of innovation, Medtronic Care Management Services has the scale and scope to create robust solutions for providers through customized remote patient monitoring technology, helping them to achieve these benefits and more.
About the Author
Author Samuel Ajizian, M.D., FAAP, FCCM, CPPS is a board-certified Pediatric Intensivist with more than 20 years of clinical practice in the Pediatric ICU. He joined Medtronic in 2015, and currently is the CMO for Patient Monitoring, and VP for Clinical Research & Medical Science for Patient Monitoring and Respiratory Interventions.