Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 5, 2020
Date Accepted: Dec 8, 2020
Date Submitted to PubMed: Jan 5, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mobile app-based Remote Patient Monitoring in Acute Medical Conditions: A Prospective Feasibility Study Exploring Digital Health Solutions Clinical Workload during the COVID Crisis.
ABSTRACT
Background:
Digital remote patient monitoring (RPM) can add value to virtual wards; this has become more apparent in the context of the COVID-19 pandemic. Healthcare providers are overwhelmed resulting in clinical teams spread more thinly. We aim to assess the impact of the introduction of an app-based RPM (Huma Therapeutics) on a clinician's workload in the context of a COVID-19 specific virtual ward.
Objective:
To assess if the implementation of a mobile app-based remote patient monitoring solution can impact clinician workload.
Methods:
A prospective feasibility study was carried out over one month where clinician workload was monitored, and full-time equivalents (FTE) savings equated. An NHS hospital repurposed a telephone-based respiratory virtual ward for COVID-19. Amber status (NHS definition) COVID-19 patients were monitored for 14 days post-discharge to help identify deteriorating patients earlier. A smartphone-based app was introduced to monitor data points submitted by the patients with telephone calls used for communication.
Results:
56 patients were enrolled in the app-based virtual ward. Digital RPM reduced the number of phone calls from a median total of 10 to 4 over the monitoring period. There was no change in the mean duration of phone calls (8.5minutes), and no reports of readmissions or mortality. This equates to a mean saving of 47.60 working hours. This translates to 3.30 fewer FTEs (raw phone call data), resulting in 1.1 fewer FTEs required to monitor 100 patients when adjusted for time spent reviewing app data. Individual clinicians were averaging 10.9 minutes per day.
Conclusions:
Smartphone-based RPM technologies may offer tangible reductions in clinician workload at a time of severe service strain. In this small pilot, we demonstrate the economic and operational impact digital RPM technology can have in improving working efficiency and reducing operational costs. Whilst this particular RPM solution was deployed for the COVID-19 pandemic, it may set a precedent for wider utilisation of digital RPM solutions in other clinical scenarios where increased care delivery efficiency is sought.
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