The effect and implementation of the COVID Box, a remote patient monitoring system for patients with a COVID-19 infection in primary care: a matched cohort study

At the onset of the COVID-19 pandemic, the pressure on hospitals increased tremendously. To alleviate this pressure, a remote patient monitoring system called the COVID Box was developed and implemented in primary care. The aim was to assess whether the COVID Box in primary care could reduce emergency department (ED) referrals due to a COVID-19 infection. A matched cohort study was performed between December 2020 and June 2021. Patients with a COVID-19 infection in need of intensive monitoring based on the clinical judgement of their own general practitioner received the COVID Box in primary care combining home monitoring of vital parameters with daily video consultations. The control group was retrospectively matched by propensity score matching. We conducted a subgroup analysis in higher-risk patients with oxygen saturation measurements, considering oxygen saturation as a critical parameter for assessing the risk of a complicated infection. We included 205 patients, of whom 41 patients were monitored with the COVID Box (mean age 70 and 53.7% male) and 164 in the control group (mean age 71.5 and 53% male). No difference was found in ED referrals between the intervention and control groups in our primary analysis. In the subgroup analysis, we found a nonsignificant trend that remote monitoring could reduce the ED referrals. While the overall study found comparable ED referrals between groups, the subgroup analysis suggested a promising prospect in reducing ED referrals due to remote monitoring of higher-risk patients with acute respiratory disease in primary care.