Completed evaluations

Evaluation of remote monitoring during Covid-19: phase 2

Phase 2 of RSET and BRACE's study of remote monitoring models for Covid-19 patients assesses the use of these models during the second wave of the pandemic while taking on board lessons from the first phase.

This is a RSET and BRACE project funded by NIHR.

Summary

The problem:

COVID-19 patients can experience very low oxygen levels, without feeling breathless. Patients may not realise there is a problem until they become extremely unwell, risking being admitted to hospital too late.

To address this, COVID-19 remote home monitoring services were developed and later rolled out across England. Patients monitored oxygen levels at home using an ‘oximeter’ (a small device which clips on to your finger) and sent these readings to providers via phone or technology (e.g. an app). Patients could access further care if needed.

We did not know whether these services worked, or what people felt about them.

We looked at:

  • How services were set up and used in England
  • Whether services work (e.g. by reducing deaths and length of hospital stay)
  • How much they cost
  • What patients, carers and staff think about these services (including differences between groups and telephone vs. technology).

What we did:

During the second wave of the pandemic, we used data available at a national level and conducted surveys (28 sites) and interviews (17 sites) with staff, patients and individuals involved in developing/leading services nationally.

What we found:

Our findings did not show that services reduce deaths or time in hospital. But these findings are limited by a lack of data.

Staff and patients liked these services, but we found some barriers to delivering and using the service. Some groups found services harder to use (e.g. older patients, those with disabilities and ethnic minorities).

Using technology helped with large patient groups, but it did not completely replace phone calls.

Conclusion:

Better data is needed to know whether these services work. Staff and patients liked these services. However, improvements may make them easier to deliver and use (e.g. further staff training and giving additional support to patients who need it).

 

The full study protocol for the evaluation can be downloaded here.

 

Outputs

  • Final report: A rapid mixed methods evaluation of remote home monitoring models during the COVID-19 pandemic in England ·
  • Explainer: Virtual wards and Covid-19: An explainer 14/03/2022
  •  Infographic: oximetry in care homes rapid evaluation

Peer reviewed published articles:

Preprints:

Slide sets:

Presentations: 

  • HSRUK 2021 Conference workshop session: Understanding the impact of COVID Oximetry @home programme among COVID-19 patients in England - watch here.

  • HSRUK 2021 Conference workshop session: What can we learn from COVID-19 about how to fund, co-ordinate and deliver rapid service evaluation in health and care? Presented by Manbinder Sidhu from the BRACE team - watch here.

  • Panel discussion at Leaders in Healthcare Conference 2021, 8-11 November, London (online and in-person) - watch here.

  • Health Service Journal: Webinar - What needs to happen if remote monitoring is to truly enhance patient outcomes and system efficiencies?

Project team

  • Naomi Fulop
  • Cecilia Vindrola
  • Manbinder Sidhu (NIHR BRACE)
  • Chris Sherlaw-Johnson
  • Theo Georghiou
  • Lauren Herlitz
  • Holly Walton
  • Sonila M Tomini
  • Nadia Crellin
  • Ian Litchfield (NIHR BRACE)
  • Jo Ellins (NIHR BRACE)
  • Efthalia Massou
  • Stephen Morris
  • Pei Li Ng

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