Evaluation of remote monitoring models during the Covid-19 pandemic in the UK: Phase 1

RSET and BRACE collaborated on a study of remote home monitoring methods, or 'virtual wards' for Covid-19 patients.

Project

Published: 15/06/2021

Project status: Completed

This is a RSET and BRACE project funded by NIHR.

Researchers from the NIHR-funded BRACE Rapid Evaluation Centre have worked with RSET, Public Health England and NHS England & NHS Improvement to conduct a rapid evaluation of the national NHS remote home monitoring model for COVID-19 patients.

Phase 1 of this study explored staff experience of using models like pulse oximetry at home during the COVID-19 pandemic, looked at the use of data for monitoring progress, and documented how staffing and resource allocation can affect the success of these models.

This involved a study of eight NHS sites which implemented a range of COVID Oximetry @ home models set up during the first wave of the pandemic.

Here are some of the key findings:

  • Staff described high levels of patient engagement.
  • Staff felt the remote monitoring of patients reduced their risk of contracting Covid-19.
  • The mortality rates appeared to be low compared to other Covid-19 patients, but as there was no control group, it is difficult to compare effectiveness.
  • Patient/ carer training is key to making these tools a success. There was some indication that models based on telephone calls, rather than apps were more inclusive as they include patients without internet access or technological literacy.
  • Coordination between primary and secondary care facilitated implementation.
  • Some concerns were raised about how sustainable these services are: they were set up quickly with discretionary input but need dedicated funds and management support.
  • There also needs to be better integration with NHS Test and Trace to streamline the referral process.

The study drew out the lessons learned for development and implementation of this model of care across the country for winter 2020-21 and were disseminated widely across the country. Findings were used in the decision by the National Incident Response Board to support the national roll out of this model in December 2020: COVID Oximetry@home (CO@h).

Evaluation slide set (project overview and phase 1 results)

Pre-print: The implementation of remote home monitoring models during the COVID-19 pandemic in England

Full study protocol for this evaluation

Outputs
  • Vindrola-Padros C, et al. Remote home monitoring (virtual wards) during the COVID-19 pandemic: a systematic review. [pre-print] (Link)
  • Vindrola-Padros C, et al. The implementation of remote home monitoring models during the COVID-19 pandemic in England. [pre-print] (Link)
  • Vindrola-Padros C, et al. The implementation of remote home monitoring models during the COVID-19 pandemic in England. EClinicalMedicine, doi: 10.1016/j.eclinm.2021.100799. (Link)
  • Greenhalgh T, et al. Remote Management of covid-19 using home pulse oximetry and virtual ward support. BMJ, doi: 10.1136/bmj.n677  (Link)
Presentations
  • Naomi Fulop and Steve Morris presented emerging findings from phase 1 rapid literature review and empirical study of remote home monitoring models to the PHE, NHSE, NHS Digital and NIHR on 17th September 2020.
  • Naomi Fulop presented to The Patient Safety Collaborative Learning Network (90+attendees) on 29th September 2020.
  • The team have contributed findings from phase 1 study in a presentation to the National Incident Response Board (NIRB) on the 30th September in relation to potential national roll-out of these models.
  • Naomi Fulop presented to the Covid-19 Community of Practice for pulse oximetry: Evaluation meeting (30+ attendees) on 30th September 2020.
  • Naomi Fulop presented to the North West Coast Managing Deterioration Patient Safety Network (200+ attendees) on 1st Oct 2020.
Project team
  • Naomi Fulop
  • Chris Sherlaw-Johnson
  • Cecilia Vindrola
  • Theo Georghiou
  • Sonila M. Tomini
  • Steve Morris
  • Pei Li Ng
  • Jo Ellins (NIHR BRACE)
  • Manbinder Sidhu (NIHR BRACE)
  • Kelly Singh (NIHR BRACE)

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