Remote monitoring in virtual wards for acutely unwell patients being managed and treated on an ambulatory care pathway: feasibility study
At a Glance
VIABLE (Remote monitoring in virtual wards for acutely unwell patients being managed and treated on an ambulatory care pathway: feasibility study) will provide Acute Hospital at Home patients with a system of remote monitoring equipment that will measure a range of their vital-signs. Patients will be asked to take the equipment home with them and use it for the duration of their time on the Acute Hospital at Home virtual ward. Select vital-signs data will be transferred in near real-time to a clinicians dashboard viewable by the NHS Acute Hospital at Home team.
The aim of this research is to assess the feasibility of monitoring virtual ward patients remotely using vita-sign monitoring devices. The study will also assess the usability of the devices and the efficacy of remote data transfer.
Why IS THIS important?
Virtual wards are being rolled out across the NHS to allow safe home treatment of acute illnesses under hospital supervision. The kind of monitoring available on these virtual wards varies greatly with most using some combination of regular home visits and remote sensors. However, the way in which these are used is not standardised and evidence for best practice needs to be strengthened. Where remote sensors are used these often require the patient to take the measurement and report the result by phone. This can lead to the possibility of inaccurate readings being reported that can lead to unnecessary review or present a safety risk for patients.
Automated remote vital-sign monitoring has the potential to reduce the number of home visits nurses need to carry out to perform vital-sign observations, offers the possibility to prioritise face-to-face review of those most in need and reduces the risk of self-report errors.
The VIABLE feasibility study will look at 35 patients using a remote vital-sign monitoring platform whilst admitted to the Hospital at Home virtual ward. This will include a pulse oximeter to measure blood oxygen levels and a vital-sign chest patch that will measure pulse and breathing rate.
Each patient will also be provided with a blood pressure monitor and a thermometer. Patients taking part in the study will have an acute illness (such as breathlessness or an acute infection) and will have been assigned ongoing care via the virtual ward. Participants will be asked to complete a short interview about their experiences at the end of their study period.
The VIABLE study will check that data collected via the monitoring system is efficient and accurate. The study will assess whether blood pressure monitoring and thermometer use (which can be difficult for patients to manage by themselves) are feasible in this potentially frail and elderly cohort. The study will also confirm that all the equipment is not intrusive and is easy to use. Clinical staff will be invited to contribute to the refinement of the clinical dashboard to ensure it is helpful for remotely evaluating the patient’s status and easy to use.
We will use our findings to design further research into the remote monitoring system and how this can be implemented in virtual ward environments.
VIABLE is preparing to begin recruitment at Oxford University Hospitals NHS Trust.