At the latest HTN Now event Jamie Innes, Inhealthcare’s Product Director, offered an insightful discussion on how the approach to the delivery of health and care services is changing, focusing on the evolution of virtual care and virtual wards.
To introduce the session, Jamie establishes the primary themes of the virtual care-orientated webinar, which includes real-life case studies of the deployment of virtual care and virtual wards, the benefits of this deployment to healthcare providers and patients, and how ICSs should consider using virtual wards across regions in-line with guidance from NHS England.
Providing some background context into the operations of Inhealthcare, Jamie says: “We work with our customers to develop over 100 different digital services across a wide range of different clinical specialities.
“These are used to support patients in their own homes but also in challenging environments such as care homes. We support a variety of different long-term conditions, but we also appreciate that every NHS organisation is slightly different, and we work with our customers on developing pathways that are bespoke to their local population and requirements.”
Setting the scene as to how the face of the NHS has irretrievably changed in light of the COVID-19 pandemic, Jamie comments: “Obviously, the pandemic has had a profound impact on the way the NHS delivers care to its patients. Throughout the pandemic, the NHS adapted rapidly to new challenges and through the introduction of remote patient monitoring and existing technologies, such as video conferencing, the NHS was able to drastically change its operating models and allow for care to be deliver at uncertain times.”
However, as we “exit from the pandemic,” Jamie explains, the NHS is faced with “even bigger challenges,” such as “managing an ever-growing backlog of appointments and procedures, whilst at the same time continuing to support an increasing number of patients with long-term conditions and complex health needs.”
Highlighting the benefits of remote monitoring in supporting efforts to tackle the backlog and increasing caseloads of patients suffering from long-term conditions, Jamie states: “the approach to managing patients remotely and within their own homes dramatically reduces the needs for face-to-face appointments and frees up fixed capacity within the NHS to focus on activities, which is very important with the current backlog of appointments.”
Jamie outlines that additional benefits of remote monitoring include, “allowing NHS staff to focus their resources more effectively by only reviewing patients when their observations deteriorate and allow for staff to manage their growing caseloads more effectively by automating many manual processes.”
The virtues of this technology, Jamie says, do not just span across NHS organisations and staff, however. Patients are also benefitting from the implementation of remote monitoring services. “One of the main benefits for patients is the freedom remote monitoring technologies can provide to them in reduction of travel and face-to-face appointments, so they can continue to live their own independent lives.
“In addition, patients who we have spoken to about their experiences often point towards the reassurance that remote monitoring technologies provide and the knowledge that healthcare professionals are able to spot trends and intervene, if necessary,” Jamie says.
Demystifying the difference between virtual wards and virtual care, Jamie says: “Virtual care is what we would traditionally see as remote monitoring for pre-existing long-term conditions who are not at a high acuity level.” Virtual wards on the other hand, Jamie says, are “designed for patients with a higher acuity level who may require more frequent continuous monitoring to spot deterioration.”
Moving on from the differences between two forms of care delivery, Jamie focuses on the implementation of Inhealthcare’s very own virtual care products – starting with Oximetry@home. “This was used very heavily across the pandemic to monitor those patients who were at risk of hospitalisation and deterioration and today it’s been used by over 25,000 patients across the UK to allow healthcare professionals to review patients and intervene as necessary.
The healthcare platform, Jamie adds, uses “multiple different communication channels so that patients can choose the right technology that’s appropriate for them and their situation, and that includes automated phone calls, text messages, online portal and a smart phone app.”
Highlighting Inhealthcare’s operations with virtual care tech further, Jamie speaks of the organisation’s support of Surrey Heartlands ICS in monitoring patients with high blood pressure and suspected hypertension.
“The remote monitoring service allowed patients to submit their blood pressure and heart rate readings for a short period of time, via different communication channels, and the Inhealthcare platform calculates averages and displays alerts to healthcare professionals for them to review patients who might require further care and monitoring.”
On the here and now, Jamie discusses the timely topic of NHSE’s recent guidance on building the capacity of community services in delivering care at home and the role of the ICS within this development, where he says: “ICSs are being asked to support the delivery of virtual wards to manage that early discharge of patients to free up bed capacity and avoid readmission of patients.
“Over the next 20 months,” Jamie continues, “NHSE expects ICSs to have completed the deployment of virtual wards and their plan is to ICSs to have 50 beds per 100,000 of their population – to support this delivery, NHSE is providing £200,00 million this financial year and £250,000 million next year.
Shedding some light on how the virtual wards are to be implemented in line with the guidance, Jamie says ,“they should be used to support admission avoidance for high-risk patients or to facilitate early discharge of patients,’ as well as to, “make use of new technologies and to have clear criteria for the step-up and step-down of patients within their caseload.”
To provide safe and robust virtual wards, Jamie explains that it is essential to be able to continuously monitor patients if required. This is so they have the ability to monitor in real-time, know an issue before it happens, and reduce the cost on healthcare services.
Jamie highlights that Inhealthcare have created a skin-patch that can monitor vital signs: “This will allow healthcare professionals to receive real-time information on a patients vital sign measurements and be able to intervene rapidly in the event of a fall, or something of that nature.”
The disposable skin-patch is connected to a mobile device, and it can be used to capture a variety of vital sign measurements. In addition, it also captures activity such as steps, body posture and fall detection.
Highlighting how it works, Jamie explains: “This patch allows for continuous vital sign measurement over a 7-day period, and if necessary, the patients monitoring can be extended with additional patches, or they can be stepped down to alternative remote monitoring technology that doesn’t require continuous monitoring.”
The road to implementing virtual wards, however, is not as simple as introducing new technologies alone; a “whole system” approach needs to be established, Jamie says. “This will ensure services can operate at all hours and there’s integration between different elements of the health system so that providers such as 111, 999 or GP out-of-ours are all aware of patients on virtual ward programmes and are able to see their information.”
To conclude the session, Jamie says: “At Inhealthcare, we’ve got a wealth of experience in delivering these digital health services through our platform and this technology is constantly adapting and updating as new advancements become available. We’re constantly looking as to what new technologies are on the horizon to support our customers and the challenges they may face in the future.”
To view ‘The evolution of virtual care and virtual wards’ webinar click here