Remote health pathway evaluated for roll-out in Scotland

A remote health pathway for people with COVID-19 in Scotland has been evaluated for roll-out by a clinical advisory group.

Inhealthcare’s pathway, which was designed to detect and manage early deterioration among COVID-19 patients, was found to have ‘improved access to NHS services’ for those with symptoms and can now be ‘safely rolled out to help others’.

The study also found that patients had ‘positive experiences of using the system’ and staff felt ‘supported and engaged’, while the evaluation indicated that the pathway contributed to ‘increased self-management’, ‘improved resource efficiency’, and ‘reduced health inequalities’.

The research focused on a cohort of 149 patients and was based on an ‘analysis of submitted readings, patient interviews and staff surveys’, with the clinical advisory group comprised of experts from general practice, infectious diseases, respiratory medicine, intensive care, emergency medicine, the Scottish Ambulance Service and NHS24.

The pathway went live in January 2021 and enabled patients who were ‘below the threshold for hospital admission’ to self-monitor at home, with the ability to respond to clinical questions via text messages, a mobile app, web portal or phone calls.

Information gathered by the technology focused on breathlessness, oxygen saturation and temperature, among other COVID-19 symptoms – with any concerns triggering advice to call NHS services.

Bryn Sage, Chief Executive of Inhealthcare, commented: “Remote monitoring has become a very important tool for the NHS in supporting the many COVID patients who are below the threshold for hospital admission but at risk of deterioration.

“Our technology has come of age during the pandemic and, as this evaluation shows, can be safely rolled out to help more people.

“The evaluation demonstrates how effective remote monitoring can be in reaching people living in disadvantaged areas. The use of inclusive technology like the traditional telephone landline can help overcome the digital divide.”

The full report on the Inhealthcare technology – An evaluation of using Scotland’s COVID-19 Remote Health Pathway – by Dr Helen Alexander for Scottish Government’s Digital Health & Care Directorate, Technology Enabled Care Programme, found a number of outcomes.

These included: improved access to services for ‘those in greatest need’, the most severe symptoms and the lowest oxygen saturation levels; positive experiences of using the system, with most patients saying they would be ‘happy to use it again’; and that staff felt ‘engaged and supported’, and most felt the trigger levels were ‘about right’ for patients.

Other findings suggested the pathway contributed to ‘increased self-management’ thanks to the use of pulse oximeters for oxygen saturation levels, ‘effective and efficient’ use of time and resources for staff and patients, and ‘more than twice as many people from disadvantaged areas using the system than those from affluent areas’.

On the topic of self-management, the report specifically notes that, ‘Although not one of the main outcomes being evaluated for this RHP, some of the points raised by the patients interviewed suggested they were self-managing in a way they had not before’.

The author(s) adds that, ‘The definition of this outcome used in previous [sic] the previous national evaluation required people to do something in response to remote monitoring, not simply to submit readings’ – with all 14 people interviewed about COVID-19 remote monitoring having learned how to use a pulse oximeter, or having access to someone who could use it on their behalf.

Ultimately, the report concluded: ‘The Covid-19 RHP [remote health pathway] improved access to services, those remotely monitoring their symptoms had positive experiences of using the system and staff felt engaged and supported. The Covid-19 RHP can be safely rolled out to others.’

To read the report in full, or find out more about how it was conducted, access it online here.