Pilot and Feasibility Deployment of an Advanced Remote Monitoring Platform for COVID-19 in Long-term Care Facilities

Jessica R. Walter MD; Dong-hyun Kim BA; Daniel Myers BA; Marc Hill BA; Brooke Snoll BA; Jong Yoon Lee BA; Elena Kulikova BA; Katherine Fagan BA, MA; Raclyn Cauinian BS; Lily Nguyen BA; Mark Shapiro PhD; Fernanda Heitor MD; Katherine T. O'Brien MD; Shuai Xu MD


J Am Geriatr Soc. 2022;70(4):968-971. 

In This Article


We demonstrated feasibility, safety, and acceptability of remote monitoring of medically complex, residential older adults with low profile, bio-integrated wearable sensors. Though nearly 70% of participants were 80 years or older with multiple comorbidities, the system was correctly applied over 100 times by LTCF staff without injury or device failure. The design, deployment, and validation of remote monitoring systems intended for older adults should consider age, comorbidities, cognitive decline, limited mobility, skin fragility, and low technical literacy.[9] The sensor system presented here addresses many of these challenges. Figure 1C illustrates the model for sustainable and scalable programs for remote staff training and patient onboarding with automatic transmission of real-time data for healthcare decision-making at both the patient and population level. The ergonomic, waterproof, and wireless design is unobtrusive providing continuous, Intensive care unit (ICU)-grade vital sign monitoring without interrupting sleep or requiring confinement to bed or bulky bases, minimizing fall risk, disorientation, and delirium. Elderly skin is 50% thinner with increased vulnerability to shear or frictional injuries and slower healing. There were no skin injuries as a result of the hydrogel adhesives—prior work using the sensors in premature neonates demonstrated similar safety profiles.[10] This study is not without limitations. It was a small pilot at two different urban LTCFs. Therefore, our findings may not be generalizable. Conventional consumer wearables may not provide relevant biomarkers with sufficient accuracy to achieve disease prevention and surveillance. We demonstrate successful deployment of the ANNE ecosystem with a contactless trial design, virtual training, and device reusability cumulatively suggesting a viable path for scalable, sustainable distribution in LTCFs.