- This was the first national evaluation of patient and staff experiences of the rapid implementation of mixed models (tech-enabled and analogue) and analogue-only models of COVID-19 remote monitoring services across multiple care settings.
- Twenty-one sites adopted mixed models with tech-enabled and analogue (phone calls with a healthcare professional) options for symptom submission; seven sites offered analogue-only models.
- Patient and staff experiences of tech-enabled remote care were positive, suggesting remote care could feasibly reduce the burden on secondary care for COVID-19 and potentially other conditions.
- Patients who used tech-enabled modes tended to be younger, more well-educated, and to identify as White British. Older patients, patients with physical or cognitive impairments, patients living alone, and those with communication difficulties may need additional support from services to engage.
- Staff considered mixed models better for managing large patient numbers, as the work of data input was transferred to patients using tech-enabled modes. However, the functionality of systems required improvement, and all models involved some aspects of analogue communication.
Journal article information
- Journal of publication: International Journal of Medical Informatics
- Nuffield Trust contributors: Lauren Herlitz , Nadia Crellin , Dr Cecilia Vindrola-Padros , Jo Ellins , Theo Georghiou , Ian Litchfield , Efthalia (Lina) Massou , Pei Li Ng , Chris Sherlaw-Johnson , Dr Manbinder Sidhu , Dr Sonila Tomini , Dr Holly Walton and Prof Naomi Fulop
- Volume: 179
- Issue: November 2023
Abstract
Objective
To evaluate patient and staff experiences of using technology-enabled (‘tech-enabled’) and analogue remote home monitoring models for COVID-19, implemented in England during the pandemic.
Methods
Twenty-eight sites were selected for diversity in a range of criteria (e.g. pre-hospital or early discharge service, mode of patient data submission). Between February and May 2021, we conducted quantitative surveys with patients, carers and staff delivering the service, and interviewed patients, carers, and staff from 17 of the 28 services. Quantitative data were analysed using descriptive statistics and both univariate and multivariate analyses. Qualitative data were interpreted using thematic analysis.
Results
Twenty-one sites adopted mixed models whereby patients could submit their symptoms using either tech-enabled (app, weblink, or automated phone calls) or analogue (phone calls with a health professional) options; seven sites offered analogue-only data submission (phone calls or face-to-face visits with a health professional). Sixty-two patients and carers were interviewed, and 1069 survey responses were received (18 % response rate). Fifty-eight staff were interviewed, and 292 survey responses were received (39 % response rate). Patients who used tech-enabled modes tended to be younger (p = 0.005), have a higher level of education (p = 0.011), and more likely to identify as White British (p = 0.043). Most patients found relaying symptoms easy, regardless of modality, though many received assistance from family or friends. Staff considered the adoption of mixed delivery models beneficial, enabling them to manage large patient numbers and contact patients for further assessment as needed; however, they suggested improvements to the functionality of systems to better fit clinical and operational needs. Human contact was important in all remote home monitoring options.
Conclusions
Organisations implementing tech-enabled remote home monitoring at scale should consider adopting mixed models which can accommodate patients with different needs; focus on the usability and interoperability of tech-enabled platforms; and encourage digital inclusivity for patients.