Understanding the implementation and impact of remote monitoring pathways in Integrated Care Systems

We will evaluate the embedding of technology-enabled remote monitoring pathways to support virtual wards. This will draw from 4 systems and across pathways including: Pre and post-operative care post hip or knee replacements;
Heart palpitations; Respiratory or heart failure; Asthma.

Hertfordshire Community Trust identified an opportunity for pre-op support using remote monitoring (BP, HR, Temp, Sa02, BM, BMI) six weeks before surgery to reduce cancelations. To reduce length of stay, post-op remote monitoring consists of x3 daily submissions (HR, BP, Sa02, Temp), patient questionnaires and remote check ins with nurse. Since January 21, 41 patients have used/are using the Doccla system. Wards in virtual hospital split by mild, moderate and severe with varying daily records, clinician contact and contact type (phone, video, face to face).

Southend (Mid and South Essex) piloting a virtual outpatient pathway for heart palpitations to transform outpatient cardiology. To reduce 72h Holters, AliveCor (ECG device) and e-consultation questionnaire will be used to monitor palpitations, and BP@Home for blood pressure monitoring and lifestyle advice from Whzan app. Based on an estimated 20% of new referrals presenting with palpitations (1200 patients PCM), in August 2021 the trust purchased 500 BP monitors and 500 Alivecor.

Cambridgeshire Community Services uses the Doccla system for remote health monitoring for respiratory (30 active, 5 onboarding) and heart failure (9 active, 2 onboarding). Aim to manage chronic disease, and monitor of long-term oxygen therapy to reduce admissions and service use. No patient outcomes collected but patient feedback.

Northampton General Hospital expanded their COVID virtual ward to develop their remote asthma pathway (80-90 patients to date). Doccla is used to avoid admission and enable early supported discharge. Standard operating procedures (including escalation decisions) developed in April 2021, where review of vital signs are monitored twice weekly (Peak expiratory low rate (PEFR), heart rate, temp, Sp02) by asthma nurse with patient phoned daily.

Doccla specialises in the implementation and support of tech-enabled virtual wards and provides equipment for community-based monitoring with a smartphone and wearables. Includes provision of devices, patient onboarding, and a dashboard for clinicians to monitor patient data via web browser. https://www.doccla.com/