Abstract
BackgroundDigital remote patient monitoring can add value to virtual wards; this has become more apparent in the context of the COVID-19 pandemic. Health care providers are overwhelmed, resulting in clinical teams spread more thinly. We aimed to assess the impact of introducing an app-based remote patient monitoring system (Huma Therapeutics) on a clinician’s workload in the context of a COVID-19–specific virtual ward.ObjectiveThis prospective feasibility study aimed to evaluate the health economic effects (in terms of clinical workload) of a mobile app on a telephone-based virtual ward used in the monitoring of patients with COVID-19 who are clinically ready for discharge from the hospital.MethodsA prospective feasibility study was carried out over 1 month where clinician workload was monitored, and full-time equivalents savings were determined. An NHS hospital repurposed a telephone-based respiratory virtual ward for COVID-19. Patients with COVID-19 in the amber zone (according to the National Health Service definition) were monitored for 14 days postdischarge to help identify deteriorating patients earlier. A smartphone-based app was introduced to monitor data points submitted by the patients via communication over telephone calls. We then comparatively evaluated the clinical workload between patients monitored by telephone only (cohort 1) with those monitored via mobile app and telephone (cohort 2).ResultsIn all, 56 patients were enrolled in the app-based virtual ward (cohort 2). Digital remote patient monitoring resulted in a reduction in the number of phone calls from a mean total of 9 calls to 4 calls over the monitoring period. There was no change in the mean duration of phone calls (8.5 minutes) and no reports of readmission or mortality. These results equate to a mean saving of 47.60 working hours. Moreover, it translates to 3.30 fewer full-time equivalents (raw phone call data), resulting in 1.1 fewer full-time equivalents required to monitor 100 patients when adjusted for time spent reviewing app data. Individual clinicians spent an average of 10.9 minutes per day reviewing data.ConclusionsSmartphone-based remote patient monitoring technologies may offer tangible reductions in clinician workload at a time when service is severely strained. In this small-scale pilot study, we demonstrated the economic and operational impact that digital remote patient monitoring technology can have in improving working efficiency and reducing operational costs. Although this particular RPM solution was deployed for the COVID-19 pandemic, it may set a precedent for wider utilization of digital, remote patient monitoring solutions in other clinical scenarios where increased care delivery efficiency is sought.
Highlights
BackgroundOver the last decade, the world has seen a surge in the creation of virtual wards, wherein patients are managed remotely [1]
In all, 56 patients were enrolled in the app-based virtual ward
Digital remote patient monitoring resulted in a reduction in the number of phone calls from a mean total of 9 calls to 4 calls over the monitoring period
Summary
BackgroundOver the last decade, the world has seen a surge in the creation of virtual wards, wherein patients are managed remotely [1]. It is thought that web-based, digital general practice consultations and redesigned hospital support will reduce outpatient appointments by up to a third [4]. This could reduce patient trips to the hospital by approximately 30 million each year and, in turn, save the NHS over £1 billion (~US $1.35 billion) annually in new expenditure averted [4]. Digital remote patient monitoring can add value to virtual wards; this has become more apparent in the context of the COVID-19 pandemic. We aimed to assess the impact of introducing an app-based remote patient monitoring system (Huma Therapeutics) on a clinician’s workload in the context of a COVID-19–specific virtual ward
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