Study shows remote home monitoring models can support COVID-19 patients and reduce demand on hospital services

Remote monitoring- Inside
Studies indicated that models based on telephone calls were more inclusive of people without internet access or with limited digital literacy.

A study led by the National Institute for Health Research (NIHR) BRACE and RSET Rapid Evaluation Centres and undertaken by researchers at UCL, Nuffield Trust, RAND Europe and the University of Birmingham suggests that effective coordination between primary and secondary care to set up and deliver remote home monitoring models can help patients and reduce demand on hospital services during the period of COVID-19.

The study, which is a systematic review of remote home monitoring models (including ‘virtual wards’) set up internationally, for confirmed or suspected COVID-19 cases shows that primary care-led models could be more adaptable to evolving patient and system needs and easier to replicate in contexts with limited access and capacity for hospital care.

The study which is titled "Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review” and is published in the Lancet EClinicalMedicine online looks at Covid-19 remote monitoring models led by primary and secondary care across seven countries – US, Australia, Canada, the Netherlands, Ireland, China and the UK – where the models have been developed to:

  • Avoid unnecessary hospital admissions (providing appropriate care in the appropriate place).
  • Escalate cases of deterioration at an earlier stage to avoid invasive ventilation and ICU admission.
  • Facilitate early discharge from hospital so patients can be followed up safely in the community.

Using digital apps to monitor patients’ blood oxygen levels allowed a higher number of patients to be followed up compared to paper-only models, while some studies indicated that models based on telephone calls were more inclusive of people without internet access or with limited digital literacy.

Dr Manbinder Sidhu from the University of Birmingham (BRACE team) and a co-author of the study said: "Our review shows that primary care can play a central role in the coordination of remote patient monitoring models, providing more holistic care for patients and reducing the demand on hospital services. Yet, further research needs to explore the processes used to implement these models and how these might vary based on the healthcare sector, patient population, size, and approaches used for triage, monitoring and escalation."

These findings complement those from the teams’ phase 1 empirical study of remote home monitoring during the first wave of the pandemic in England which concluded home monitoring methods can help reduce the risk of contracting COVID-19 for NHS patients and staff.

The "Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review” is published in the Lancet in EClinicalMedicine.

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The Birmingham, RAND and Cambridge Evaluation (BRACE) Centre is funded by the National Institute for Health Research (NIHR) to conduct rapid evaluations of promising new services and innovations in health and social care.

The University of Birmingham is ranked among the world’s top 100 academic institutions. Its work brings people from across the world to Birmingham, including researchers and teachers and more than 6,500 international students from over 150 countries.

The authors of this study are Cecilia Vindrola-Padros, Manbinder S Sidhu, Theo Georghiou, Chris Sherlaw-Johnson, Kelly E Singh, Sonila M Tomini, Matthew Inda-Kim, Karen Kirkham, Alison Streetly, Nathan Cohen and Naomi J Fulop.

The Rapid Service Evaluation Team (RSET) comprises health service researchers, health economists and other colleagues from University College London and the Nuffield Trust.

The Nuffield Trust is an independent health think tank that aims to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.

The Birmingham, RAND and Cambridge Evaluation (BRACE) and RSET Centres are funded by the NIHR Health Services and Delivery Research Programme to conduct rapid evaluations of promising new services and innovations in health and social care.

The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

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Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services

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The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.