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The University of Oxford’s Nuffield Department of Primary Care Health Sciences, in partnership with RAND Europe, is excited to launch the DECIDE (Digitally Enabled Care in Diverse Environments) initiative, to help transform healthcare through rapid evaluation of technology-enabled remote monitoring.

Funded by a £2 million award from the National Institute for Health and Care Research (NIHR), DECIDE addresses an urgent need for rapid evaluation of technology-enabled remote monitoring. This stems from growing use of technology across health and social care, with increasing use of digital tools, devices, and applications (such as activity trackers, blood pressure monitors) to remotely monitor an individual’s health and wellbeing. The aim of remote monitoring using technology is for patients and their clinical team to seamlessly exchange information (for instance about vital signs, like heart rate), enabling on-going monitoring and management of people’s health and social care. This offers potential for real-time understanding of health and care status and proactive intervention.

However, new technologies and services are still evolving. Questions remain about how effective technology-enabled remote monitoring initiatives are, how and where they add value to existing services and how people feel about using them. An important theme of DECIDE’s research is responding to inequalities so that the evaluations take into consideration diverse groups of people.

The launch of DECIDE is an exciting milestone. Our aim is to harness the potential of technology in ways that support good health and social care for people. By swiftly evaluating and understanding the impact of technology-enabled remote monitoring, and bearing in mind that not everyone can or wants to use technology, we can ensure that people who use health and social care services can receive high-quality, personalised care that supports their needs and preferences
- Sara Shaw, Director of DECIDE and Professor of Health Policy and Practice in the Nuffield Department of Primary Care Health Sciences, University of Oxford

Working in partnership with evidence users such as NHS England, DECIDE will respond rapidly to priority areas for evaluation, generating and rapidly disseminating evidence that can support informed decision making about the development and adoption of technology-enabled remote monitoring interventions and services.

Technology-enabled remote monitoring solutions are becoming increasingly common. This is reflected in NHS policy and how services are being organised and delivered across the UK.  From elder care to chronic disease management, these technologies are thought to have the potential to enhance people’s experience of health and social care, reduce hospital admissions, and improve overall care outcomes. However, a lack of comprehensive understanding of their effectiveness and implementation poses a challenge. Real concerns remain about inequalities of access with some people not able to use technology and access services in this way. This is particularly important as many of those who might benefit from remote monitoring are older people, those living with frailty or long-term conditions for whom technology could prove challenging, especially when they’re feeling unwell.

DECIDE aims to address these gaps. Over three years, working with key stakeholders, the team will carry out multiple evaluations of remote monitoring technologies used for common conditions like heart failure, diabetes, COPD, and elder care. DECIDE brings together an experienced team, with an understanding of how technology is – and isn’t – being used in health and social care, and of the benefits and challenges it can bring. The goal is to build an evidence base clarifying the potential benefits and limitations of remote monitoring for specific contexts and groups. By identifying which approaches are most effective, for whom, and under what circumstances, DECIDE seeks to better inform policymakers, practitioners and patients/service users of the best ways of designing and delivering remote monitoring services.

Dr Sonja Marjanovic, DECIDE Lead and Director of Healthcare Innovation, Industry and Policy, RAND Europe, said:

‘This partnership between the University of Oxford and RAND Europe reflects our shared commitment to establishing rapid and robust evidence that can inform decision-making about whether, when, where and how, technology-enabled remote monitoring can support health and care services, and population health and well-being. We hope that our multidisciplinary expertise in innovation, health and social care services research and evaluation will provide incisive and timely evidence and insights on implementation and success criteria in this space, with inequalities being integral to all evaluation efforts. As DECIDE begins its journey, it promises to support wider efforts to help transform healthcare delivery, enhance patient outcomes, and contribute to the broader advancement of health and care services.’

Professor Kathy Rowan, Director of the NIHR’s Health and Social Care Delivery Research (HSDR) Programme, which is funding DECIDE, said:

‘NIHR welcomes the launch of DECIDE, the fifth rapid evaluation team that our Programme has funded, the first two dating back to 2017. DECIDE will join with these other teams scoping and producing rapid evidence on prioritised topics, agreed with the Programme, while also building capacity, informing methods and practice and joining an existing research community in rapid evaluation.’

DECIDE is now operational and welcomes collaborations, more information is available via the website.

 

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