- Cardiologists to ‘start off safe’ with low-risk, tech savvy patients
- Approach shows how clinicians are meeting NHSE challenge
- Roundtable gathers feedback from frontline staff
Cardiologists are creating new virtual wards for patients with heart failure and atrial fibrillation to avoid unnecessary overnight stays in hospital. Speaking at a roundtable hosted by Inhealthcare, consultants said they are “starting off safe” with a small number of low-risk, technologically capable people to show the approach works before expanding to care for more patients at home. They added that as prerequisites, individuals should understand the virtual ward is unable to provide 24-7 care and be able to call for help if they became unwell.
The roundtable provided valuable insights into how clinicians are responding to the challenge from NHS England to create 40 to 50 virtual ward beds per 100,000 of the population by December 2023. Inhealthcare, which delivered the UK’s largest remote monitoring programme during the pandemic, is using its technology to help NHS organisations establish and expand virtual wards. The company has grown by co-designing digital health services with clinicians. It hosted the roundtable to gather vital feedback from frontline healthcare professionals who are setting up virtual wards.
Consultants said they would take baseline readings from patients in a hospital setting before adding heart failure and AF patients to a virtual ward. They would be happy with a number of spot readings per day, rather than a continuous stream of data, as even the most intensely monitored patients in hospital are usually subject to four to six readings per day. Specialist nurses then would “look, review and act” to contact patients at home if readings fall outside parameters set for each individual. In these circumstances, patients would also be advised to seek help.
“It’s about starting off safe with the least frail patients who are tech savvy, demonstrating that it works in a safe environment and then expanding,” said one of the consultants whose Trust wants to create a virtual ward for cardiology patients. “For the cohort of patients who are not that unwell and are ambulatory, we can give them medication and explanation and get them home in a virtual ward. Otherwise, they would stay in hospital.”
Consultants in other specialisms may take a different approach to suit their patients. Inhealthcare’s technology allows for a step up/step down model, offering different frequencies of monitoring from one or two times a week to several times every day, according to individual need. It is clear from discussions that clinicians do not want to be deluged with unnecessary endless streams of data. However, trend analysis based on a set period of readings would be very useful to clinicians. Out of hours, patients should know who to contact if their readings fall out of range when specialist teams are off duty. In these cases, Inhealthcare can push advisory messages to patients.
Patients using Inhealthcare services have a choice of digitally inclusive communication channels including smartphone app, web browser, SMS text and telephone landline. An evaluation for the Scottish government found the company’s approach improved access to NHS services and reduced health inequalities with more than twice as many users from disadvantaged areas.
During the pandemic, Inhealthcare delivered life-saving care to more than 25,000 Covid patients with the Oximetry @home service across southern England. Clinicians are using the same tried and tested infrastructure to build virtual wards and help patients self-manage other conditions such as hypertension, COPD, asthma, heart disease, diabetes, depression, malnutrition and cancer.
The company’s technology platform has open and published APIs for connecting to a diverse range of medical devices for virtual wards such as blood pressure monitors, oximeters, weighing scales, forehead thermometers and wearable patches taking physiological measurements.
Product director Jamie Innes chaired the roundtable, which took place under Chatham House rules. Speaking afterwards, he said: “The overriding message from our discussion is that virtual wards are ‘starting off safe’ before looking to expand, as in the case of our consultant cardiologists. It is important to remember that a lot of what is needed to create a virtual ward is already in place. Above all, our advice is to keep it simple when designing digital health services and put the patient at the centre of everything you do.”
To find out more about virtual wards, go to https://www.inhealthcare.co.uk/digital-health-services/virtual-ward/