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

doi:10.1016/j.cmpbup.2022.100061

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

Comput Methods Programs Biomed Update. 2022:2:100061. doi: 10.1016/j.cmpbup.2022.100061. Epub 2022 Jun 5.

Authors

Affiliations

¹ Medical Information Center, Kyushu University Hospital, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan.
² Global Communication Center, Grameen Communications, Bangladesh.
³ Institute for Asian and Oceanian Studies, Kyushu University, Japan.
⁴ Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Japan.
⁵ Graduate School of Advanced Information and Electrical Engineering, Kyushu University, Japan.

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.

Keywords: COVID-19 triage; Clinical safety by telemedicine; Home delivery healthcare service; Quarantine support.