Recovering from COVID-19 at home using virtual technology

It's not every day that a virtual hospital moves into a family home. But that's what happened at John and Joanne Rohrscheib's house in Mondovi, Wisconsin, after John contracted COVID-19.

On Nov. 4, the 84-year-old retired implement dealer had serious leg pain and a fever. He and Joanne figured the pain was due to an accident from the previous year, but they wanted to get it checked out. They traveled to the Emergency Department at Mayo Clinic Health System in Eau Claire, Wisconsin. During that visit, he was tested for COVID-19 because he had a fever. John was sent home that evening, but he received a call the next day to let him know that his COVID-19 test was positive.

"We were shocked," says Joanne, 83. "I figured if he had it, then I had it, too, since I drive him to his appointments."

John needed to return to the Emergency Department on Nov. 7 because he was having trouble breathing at home and the pain in his legs had worsened. This time, he was admitted to the hospital.

"When I went in, I was short of wind," says John. "They did a good job for me and got me started on meds right away."

While in the hospital, John received the first dose of remdesivir — an antiviral drug that prevents the COVID-19 virus from copying itself.

"Most hospitalized patients who are positive for COVID-19 and have symptoms of the virus, such as shortness of breath, require a daily dose of remdesivir for five days. It is given intravenously, so this occurs while the patient is in the hospital," says Margaret Paulson, D.O., a Mayo Clinic Health System hospitalist. "However, there is a new option for patients with conditions previously managed in a hospital called Mayo Clinic Advanced Care at Home."

Dr. Paulson also is the chief clinical officer for Mayo Clinic Advanced Care at Home. The program delivers comprehensive, complex care to patients from the comfort of home through high-quality virtual and in-person care and recovery services. Patients in the program are monitored virtually 24/7 by a physician-led care team from a command center using technology installed in patients' homes to track vital signs, medications and infusions.

The team virtually connects through video with patients at home, where paramedics, nurses or other support team members are available to oversee medications, IV fluids or otherwise be the care team's hands.

While in the hospital, Kasey Peissig, the nurse manager for Mayo Clinic Advanced Care at Home, explained the service to John and Joanne.

"John was a good candidate for the program because his medical condition was relatively stable but still required an acute level of care," says Kasey. "We would be able to meet all his care needs in the comfort of his home through this program."

After discussing it, John and Joanne decided it was the right option for them.

"John has had home health care before, but I knew this was different," says Joanne. "As she explained it, we knew we wanted to try it and see. And I knew they were short of beds."

An increase in COVID-19 cases in the area had led to a rise in number of patients requiring hospitalized care and full hospitals across the region.

"Unfortunately, there have been recent instances when 100% of our hospital beds were full. Mayo Clinic Advanced Care at Home helps us safely decompress the hospital and open beds for other patients," says Dr. Paulson. "Every little bit helps during these challenging times, and Mayo Clinic Advanced Care at Home is an example of how we are evolving to meet the health care needs of our communities."

After three days in the hospital, John was transferred home and admitted into the program on Nov. 10. A team of nurses, community paramedics, advanced-practice providers, doctors and other health care professionals brought the hospital to the couple's home, including the technology that would connect him to his virtual care team.

"Not every patient who is positive for COVID-19 will qualify for this service, but for those who do, it can be a game-changer," says Dr. Paulson. "It lets them recover safely at home and allows the care team to be at the patient's bedside 24/7 at the push of a button, which can be very reassuring for them when they are acutely ill."

Having advanced medical technology in their home didn't scare John or Joanne.

"They wheeled him in the house and started setting everything up. They made sure everything was working and showed me how to it use it. It was very clear and very simple," says Joanne. "I didn't have to worry if he was having trouble breathing or was uncomfortable because I could just call for help. The team helped us feel very comfortable with all of it."

Their attitude doesn't surprise Kasey.

"Both he and Joanne were very interested in participating in our program and did well with the technology," Kasey says. "They described themselves to me as interested in learning and enjoy having new experiences, so this was a good fit."

John received hospital care at home for two additional days. During that time, the team monitored his vital signs, assessed his overall health condition, drew blood for a lab test and gave him the last dose of remdesivir. He was discharged from Mayo Clinic Advanced Care at Home on Nov. 12.

Another program benefit during the COVID-19 pandemic was that John and Joanne could remain together during his recovery. Visitor restrictions in the hospital would have prevented Joanne from being at John's bedside, especially as Joanne tested positive for COVID-19 a few days later. So far, her symptoms have been mild, and they have been able to recover together.

The couple is looking forward to getting back into a routine after the pandemic. For John, that includes daily 6 a.m. coffee time with his friends, and mowing his lawn at his home and at his son's farm. Joanne is looking forward to altering clothes, and spending time with her 10 grandchildren and six (soon-to-be seven) great-grandchildren.

The Rohrscheibs say they highly recommend the program and the care team to others.

"The nurses were always so pleasant," says Joanne. "They took their time and made sure you understood they were there to help. They made you feel like they were enjoying what they were doing."