Remote monitoring of COVID-19 patients in primary care and secondary care

What was the aim or problem?

Tech supported remote monitoring was introduced into three sites in partnership with NHSX in April 2020 as part of a response to COVID-19.

The work included deployment in secondary care at Watford General Hospital and primary care through ‘hot hubs’ in North West London STP. 

This first phase was carried out over a four week period to meet the predicted spike in COVID-19 cases at the height of the pandemic. Subsequently, remote monitoring was introduced at a further five London sites.

What was the solution?

  • Digital remote monitoring to enable a 'Community Virtual Ward'.
  • Rapidly identify deteriorating patients with COVID-19 symptoms, enabling clinicians to react faster, avoid further complications and better manage system capacity and therefore improve overall survival.
  • Medopad / Huma provided their COVID-19 remote monitoring solution mobile app and clinicians dashboard pro bono.
  • Patients require access to a personal smartphone (Apple or Android) to run the mobile app.
  • The clinical team involved in observing the data and initiating video consultation require access to appropriate hardware (laptop or desktop) with an active internet connection.

What were the challenges?

  • The COVID-19 outbreak put significant pressure on healthcare systems in the UK, resulting in major changes to care delivery.
  • Monitor the progression of COVID-19 symptoms more frequently, without increasing the physical demand on clinical sites, so patients are sent to hospital when the time is right.
  • Remotely monitor patients following discharge so they can be informed of disease progression.

What were the results? 

  • Contain virus spread by keeping those with symptoms and those who are high risk at home.
  • Optimise triage and allocate appointments to those with the greatest need.
  • Identify and act on deteriorating patients using remotely recorded vital signs and patient recorded outcome measures (recorded three times a day), therefore improving patient outcomes.
  • Make patients feel safe and connected to healthcare professionals.
  • Alleviate operational pressures on healthcare practitioners. 

Testimonials

Patient feedback: “I just want to say a huge thank you for the fantastic level of care I received when I was unwell. Your dedication, the daily phone calls, access to the app and delivering all my medications to me were greatly appreciated.” 

Clinician feedback :“We’ve been able to recognise changes and prompt a medical review or treatment that could prevent a hospital admission or even a near-death experience. This technology is good and works well.”

For more information

The learning and good practice from this project has been developed into a full Blueprint. This is a step-by-step guide which can be used by other trusts and health organisations to carry out the digital transformation more quickly and cost effectively.

The Blueprint and supporting Blueprint on a page are available to see on the FutureNHS platform. 

If you don’t already have access to this workspace then please email gdeblueprints@nhsx.nhs.uk and this can be quickly set up.

NHSX appointed Kent Surrey Sussex Academic Health Science Network (KSS AHSN) to complete a rapid evaluation of the experience of staff and patients at these first pilot sites. The purpose was to look at the early suggested impact of tech-enabled remote monitoring and how patients and clinicians found it. You can view a summary of findings here.