Seattle's Harborview Medical Center uses home assessment program for COVID-19 monitoring

Nurses and doctors at Seattle’s Harborview Medical Center have begun offering a home assessment program for testing of minimally symptomatic individuals for COVID-19 infection. A report in the journal Clinical Infectious Diseases, published on March 12, looks at how the home assessment program works and how it might be used in other novel outbreaks.

In this program, believed to be the first in the nation, a home assessment team (HAT), consisting of a doctor, a nurse, a site administrator, and one or more individuals who observe and assist with donning and doffing personal protective equipment (PPE) performs a house call to assess patients suspected of having COVID-19.

The teams go to an individual’s home after a public health official or a doctor determines that they meet the CDC’s criteria for COVID-19 testing. Doctor and nurse don their PPE and go in to speak with the patient and get the swabs for testing.

Public health employees monitor patients by telephone at least until test results come back, and afterward for those who test positive but do not require hospitalization.

The process takes about three hours from dispatch to return, and that includes 30 minutes with the patient, 10 minutes to put on PPE, and 30 minutes for doffing of PPE. As of March 12, the program had assessed 15 individuals who were stable and did not need hospitalization, with two positive results.

This program could be a scalable model that would reduce the costs of treatment and reduce the demand for resources to isolate and care for patients. The authors of the study emphasize that this model can also be used for testing in unconventional settings such as airports or ships.