The COVID-19 pandemic combined with rapidly advancing technology, increasing pressures on health services and an ageing population, have all catalysed a rapid rise in the use of remote health monitoring. Dr Sadia Khan, consultant cardiologist at Chelsea and Westminster Hospital NHS Foundation Trust – one of the top performing Trusts in the country and a leading national centre for research, innovation and discovery in the NHS – explores how remote monitoring has fast become part of everyday healthcare
Remote Patient Monitoring (RPM) is not new. We have been working on remote monitoring solutions and how we provide health care differently for some years. My first experience of this at scale was using the smartphone-based Kardia app in the community to look for the common heart rhythm disorder known as atrial fibrillation. Our community embraced the technology because we were able to provide expertise that would normally be found only in hospitals, in people’s homes, workplaces and the facilities they use most often such as supermarkets.
This really sparked my interest in how we use technology to not only improve the care we provide but to really improve the experience of that care for patients and staff. For example, another project involves a wearable patch to monitor three key indicators of patient deterioration every two minutes – heart rate, breathing rate and temperature – without having to wake up or disturb the patient to take these readings manually every four hours. Our pioneering work pre-COVID gave us a good foundation to expand our use of trackers, monitoring devices, patient portals, self-management solutions and remote consultations to aid care remotely, as in-person hospital visits were restricted with social distancing measures in place.
In the last year and a half, we have accelerated at pace to grow our remote monitoring portfolio. We quickly implemented ‘COVID Virtual Wards’, which enabled us to remotely care for 300 patients in the comfort of their own home. Patients attending A&E who were diagnosed with COVID-19 but were not seriously ill, and recovering patients on an inpatient COVID-19 ward, were sent home with an inexpensive portable pulse oximeter device and asked to measure their blood oxygen saturation levels from home. They then entered the reading into the HUMA app, which clinicians then reviewed and offered advice and guidance as required. In more serious cases, patients were invited to attend the hospital.
Our ability to respond quickly to the evolving needs of our patients is thanks to our CW Innovation programme, a joint initiative between the Trust and our charity, CW+, which identifies, tests and scales high-impact innovations that improve patient care, patient experience and the way we run our hospitals. Our Klick app and our DBm-Health app are two other examples of how we’ve responded quickly in the pandemic to deliver high-quality, remote care to patients.
The Klick mobile app, codesigned with ViiV Healthcare, allows patients with HIV to manage appointments, complete health assessments, review results and communicate with their healthcare team from the comfort of their own home, while the clinician-facing technology facilitates swift assessment of patients’ needs, providing them with improved access to the most appropriate care.
The DBm-Health app has been codeveloped with Sensyne Health to enable patients with diabetes to remotely monitor blood glucose levels, while allowing clinicians to see their results, stay in regular contact with them, and reduce the need to go into the hospital.
These examples demonstrate how RPM gives patients much greater involvement in the management of their own health, while simultaneously providing peace of mind that vital health information is being monitored by professionals elsewhere.
Without doubt, this type of remote technology activates patients to more closely manage their condition and empowers them to take action on a daily basis, not just when they visit their doctor. Klick and DBm-Health are great examples of how we can innovate and use the pandemic to encourage more patients to take responsibility for their own health and make better health and lifestyle choices to improve their mental and physical wellbeing in the long-term.
It’s not just the patient that we’re empowering, it’s also staff. A lot of staff, through no fault of their own, haven’t been able to work on the frontline due to the risks of COVID-19; but have been able to continue to work remotely. Our staff have also relished the opportunity to urgently move things forward and are innovating and introducing new remote care solutions to ensure we continue to provide the best care.
I’m excited about what the future holds for remote monitoring. With the ability to extend care into the home for patients, we’re on the cusp of reshaping our healthcare systems to work better for patients and providers alike, lessening the strain on our frontline staff and providing a more integrated method of care that puts the patient in control.