Assessing remote monitoring pathways in integrated care systems

Understanding the implementation and impact of remote monitoring pathways in integrated care systems (ICSs)

Virtual wards and remote care solutions have developed rapidly during the Covid-19 pandemic to help clinicians monitor patient health at home and reduce the need for hospital visits. This project will assess the impact of remote monitoring (RM) technology on health services and patients to ensure that people with a wide range of conditions can be supported at home and in the community.

Remote monitoring systems are being evaluated across four integrated care systems (ICSs) to explore how they support care pathways for hip/knee replacements with virtual wards, and help people to manage heart palpitations and chronic diseases, including respiratory illnesses and asthma.

What can we learn from this project?

This project will result in practical and accessible implementation guidance for healthcare organisations and patients, highlighting how to make best use of remote monitoring, with a focus on the different pilot pathways. It will also support healthcare providers and commissioners looking to implement new remote monitoring pathways, including key factors for consideration during planning, set-up and delivery.

A key part of the work is addressing health inequalities through a better understanding of who is and is not well served by remote monitoring, and how patients are currently assessed, triaged and supported. This includes how sites have engaged hard-to-reach groups.

Which remote monitoring systems are being evaluated?

The four integrated care systems are:

1. Hertfordshire Community Trust and East and North Hertfordshire NHS Trust’s use of remote monitoring pre- and post-operatively for hip and knee replacements
2. Mid and South Essex’s pilot of heart palpitation RM in Southend, a combination of ECG, blood pressure monitoring and e-consultation questionnaires paired with lifestyle advice from the Whzan app, to reduce the need for a Holter monitor (a small, wearable device that keeps track of your heart rhythm).
3. Cambridge Community Service’s use of RM for respiratory patients in Luton to support chronic disease management and long-term oxygen therapy. This pathway aims to reduce avoidable admissions and manage health service capacity.
4. Northampton General Hospital’s RM asthma pathway. This service gives the asthma team access to a range of vital signs and aims to improve condition management and reduce admissions and length of stay.

You can read more about this programme on the NIHR ARC EoE website.