Remote COVID health pathway for Scotland could be safely rolled out
Evaluation of Scottish Inhealthcare RHP trial finds it improves efficiency, encourages self management, and is welcomed by patients and staff
A remote health pathway designed to support people with COVID symptoms could be rolled out to help others, an evaluation has found.
Inhealthcare’s remote monitoring technology was trialled in Scotland and an evaluation has found it contributed to increased self management among patients, improved resource efficiency, and reduced health inequalities, with more than twice as many people from disadvantaged areas using the system.
And the research found that patients had positive experiences of using the system and healthcare staff felt supported and engaged.
The research focused on a cohort of 149 patients and was based on analysis of submitted readings, patient interviews, and staff surveys.
A clinical advisory group of experts from general practice, infectious diseases, respiratory medicine, intensive care, emergency medicine, the Scottish Ambulance Service, and NHS24 designed the pathway to detect and manage early deterioration among COVID-19 patients.
Remote monitoring has become a very-important tool for the NHS in supporting the many COVID patients who are below the threshold for hospital admission, but are at risk of deterioration
The pathway went live in January 2021 and enabled patients who were below the threshold for hospital admission to self monitor at home and respond to clinical questions via SMS text message, mobile app, web portal, or traditional landline.
The Inhealthcare system allowed health boards to gather patient information about breathlessness, other COVID-19 symptoms, oxygen saturation, and temperature. And any readings of concern triggered advice to call NHS services.
A report by Dr Helen Alexander for Scottish Government’s Digital Health & Care Directorate Technology Enabled Care Programme, found the following outcomes:
- Improved access to services for those in greatest need with the most-severe symptoms and lowest oxygen saturation levels
- People had positive experiences of using the system and many felt reassured and said they would be happy to use it again
- Staff felt engaged and supported, describing the system as ‘useful and easy to engage with’ and most felt the trigger levels were about right for patients.
The report also found indications the pathway contributed to:
- Increased self management as patients learned how to use a pulse oximeter for oxygen saturation levels and when to take action
Effective and efficient use of time and resources for staff and patients
Reduced health inequalities with more than twice as many people from disadvantaged areas using the system than those from affluent areas
The findings state: “The COVID-19 remote health pathway (RHP) improved access to services.
Our technology has come of age during the pandemic and, as this evaluation shows, can be safely rolled out to help more people
“Those remotely monitoring their symptoms had positive experiences of using the system and staff felt engaged and supported.
“The COVID-19 RHP can be safely rolled out to others.”
Bryn Sage, chief executive of Inhealthcare, added: “Remote monitoring has become a very-important tool for the NHS in supporting the many COVID patients who are below the threshold for hospital admission, but are at risk of deterioration.
“Our technology has come of age during the pandemic and, as this evaluation shows, can be safely rolled out to help more people.
“The evaluation demonstrates how effective remote monitoring can be in reaching people living in disadvantaged areas and the use of inclusive technology like the traditional telephone landline can help overcome the digital divide.”
A separate peer-reviewed study of the same pathway, led by Professor Brian McKinstry, found supported self monitoring of patients with COVID-19 at home is reassuring to patients, acceptable to clinicians, and can detect important signs of deterioration.