Automated texting system saved lives weekly during first COVID surge

A life was saved twice a week by an automated text messaging system during the fraught early days of the COVID-19 pandemic and, overall, the patients who enrolled in that system were 68% less likely to die than those not using it. These insights about Penn Medicine’s COVID Watch—a system designed to monitor COVID-19 outpatients using automated texts and then escalate those with concerning conditions to a small team of health care providers—are published in the Annals of Internal Medicine.

Person wearing a face mask holds up a smartphone, reading a text message.

“At the beginning of the pandemic, we instinctually thought patients needed extra support at home, even if they weren’t sick enough or ill yet,” says a co-primary investigator of the study, Krisda Chaiyachati, the medical director of Penn Medicine OnDemand and an assistant professor of medicine. “And if they were to get very sick, we wanted to help them get to the emergency department earlier, so COVID Watch was our solution. Our evaluation found that a small team of five or six nurses staffing the program during some of the most hectic days of the pandemic directly saved a life every three to four days.”

COVID Watch was built on Penn’s “Way to Health” platform, accelerating its development from concept to deployment. Conceived March 11, 2020, COVID Watch enrolled its first patient March 23, 2020, only two weeks after Penn Medicine took in its first COVID-19 patient. Designed to help patients with the virus recover safely at home and keep hospital capacity available, the system uses algorithmically guided text message conversations with patients to assess their conditions. Twice a day, it sent routine questions to patients, such as “How are you feeling compared to 12 hours ago?” and “Is it harder than usual for you to breathe?” If a patient indicated a worsening condition, follow-up questions were asked and they were elevated to the human members of a centralized team—headed by co-author Nancy Mannion, COVID Watch’s nurse manager—who would call to check in and recommend hospitalization, if needed.

Nearly 20,000 patients have been enrolled in COVID Watch since it started.

This story is by Frank Otto. Read more at Penn Medicine News.