PAT I ENT MONI TORING
patients remain safe and minimise avoidable hospital admissions. Additional benefits have been better use of clinical time and resources; more confident and empowered care home staff; and the ability to capture richer patient data, including dementia reviews, mobility and early warning signs of deterioration. Traditionally, weekly ward rounds would be completed face-to-face by the allocated GP after reviewing patients’ medical notes from the care home staff. The pandemic and full lockdown introduced on 16 March demanded an immediate reassessment of how these patient reviews could take place, providing continuity of care while minimising unnecessary face-to-face contact. Using the digital remote monitoring technology, care home staff take regular vital signs readings and answer patients’ personalised health questions on a smartphone, tablet or computer. These readings are provided directly to Dr. Rama and his team, who can then remotely connect with carers and patients during the scheduled ward round through video link to provide health and wellbeing advice, and intervene where and when more urgent care is needed. Moreover, the system allows for more effective triage of patients, when care home staff feel a patient needs clinical intervention outside of the scheduled ward round. By providing clinical staff with real-time insight into a patient’s observations, symptoms and condition – with clinical calculations that automatically generate a Red/Amber/ Green risk rating presented via a clinician dashboard, Dr. Rama’s team is better able to prioritise vulnerable or high-risk patients and make an immediate intervention should a patient indicate signs of deterioration. Dr. Rama explains: “CliniTouch Vie asks the resident all the questions beforehand, which can make the consultation a lot quicker and more effective, giving me time back for care where it’s most needed. I have
an average of three hours allocated to review patients from both care homes one day a week, and since using CliniTouch Vie, which highlights which patients have an acute problem to review, I am saving an estimated half an hour per care home. “With this saved time, I can instead focus on improving the quality of the ward round, such as reviewing two or three patients with no acute concern, but haven’t been reviewed for two or three months based on a ‘Care Home Frailty Question Set’, which provides the team with additional information including mood, mobility and nutrition.” The solution is also minimising call- outs from care home staff to emergency departments. As Dr. Rama says: “Previously, there would be times, if care home staff felt it might take too long for one of the GP team to physically assess and triage a patient, they would bypass our team and call the paramedics instead. “This would result in the paramedic team attending the care home, who would then communicate with one of our GPs about the patient to ask about their care plan when admitting them. “However, this inevitably resulted in unnecessary call-outs, as not every patient would need to be admitted. Instead, by having the digital remote monitoring technology in place, we have real-time remote access to a patient’s status and can triage more quickly and more effectively, while also saving healthcare resources including money, time, staff and equipment. I can confidently say that there has been a significant fall in paramedic call outs since using the technology.” He concludes: “There is a huge amount of scope for CliniTouch Vie in the practice and care homes than what we’re using it for currently, but of course, it’s still early days. We aim to continue using this tool as a more efficient method of achieving our QOF targets, while improving the quality of patient care. We are completely pro-digital
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remote monitoring to augment care provision for those who need it most, and I’m really excited to continue progressing and reaping the benefits of this solution.”
Conclusion
Maximising resources while providing the best possible levels of clinical care for the vulnerable patients is vital at this current time. Digital technology is the key to remotely connecting clinical staff with the most at-risk patients and ensuring their continuity of care while they are in the safety of their own homes. Remote monitoring can help to assist with early detection of patient deterioration by providing real-time visibility of patients, empowering health teams to help prevent adverse events. This greater collaboration and insight puts everyday wellness at the forefront of patient care.
Digital solutions, such as remote monitoring, should play a key role in future models of continuous and preventative care, helping to benefit GPs, clinical and community teams and patients.
References 1
https://improvement.nhs.uk/documents/176/ Deterioration_in_adults_report_7july.pdf
2 Ghosh, S., O’Kelly, N., Roberts, E., Barker, C. and Swift, J., 2016. Combined interventions for COPD admissions within an urban setting. British Journal of Healthcare Management, 22(3), pp.123-131.
About the author
Simon Applebaum is the managing director of Spirit Digital – part of the Spirit Health Group which has been working with the NHS since 2007 to deliver effective solutions in digital health, medicines optimisation and clinical service delivery.
APRIL 2021
CSJ
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