Summary
One of the first datasets of its type, pioneers within technology-enabled virtual wards West Hertfordshire Hospital in partnership with Masimo, used hospital grade digital health platform, Masimo SafetyNet to establish a robust clinical pathway to support early discharge and readmission avoidance for patients with heart failure. Key findings include, 36% reduction (3 days) in average acute LoS, 38% reduction in readmission and excellent patient satisfaction.
Background
Following the call by NHS England for ICSs to embrace innovation and establish technology-enabled Virtual Wards, a first-of-kind study has been released by early pioneers at West Hertfordshire Teaching Hospitals NHS Trust who have developed a Heart Failure Virtual Hospital using leading digital health platform, Masimo SafetyNet®.
Designed by a local Integrated Care Service consisting of representatives across the Acute Trust, Community Heart Failure Services and primary care, the West Hert’s Heart Failure Virtual Hospital was established to allow patients to safely receive care from the comfort of their home. In doing so, a study was conducted to quantify how this technology-enabled Virtual Ward could (1) safely reduce acute length of stay through early discharge and (2) deliver high patient outcomes through preventative readmission, all whilst maintaining positive patient experience.
To establish the Heart Failure Virtual Hospital, West Hert’s in partnership with technology providers, Masimo, developed a comprehensive clinical pathway and platform customised for eligible patients. At the centre a Virtual Hospital monitoring hub was formed to collate and monitor patient data, sent directly via Bluetooth from the Masimo monitoring app on the patients mobile device. Automated vital signs readings were recorded three times per day, as well as daily questionnaires and phone calls by a Virtual Ward nurse and daily Virtual Wards rounds by a heart failure consultant.
Key outcomes
The study, which is the first datasets of its type, collated data across length of stay, readmission rate and patient experience for 183 patients. Preliminary analysis collated the following key findings:
- Acute length of stay was significantly reduced through early discharge
- 36% reduction (3 days) in average acute LoS – mean acute LoS was 5.8 days compared to 9.1 days for patients not onboarded into the Virtual Ward for the same period
- 68% of patients (125) were successfully discharged after a Virtual Ward stay
- Preventative readmission indicated strong decline
- 11% reduction in readmission rate into the acute following 30-day follow-up with a primary HF diagnosis – 3.2% for Virtual ward vs. 3.6% for non-Virtual Ward group
- 38% reduction in readmission rate for all causes – 9.6% for Virtual Ward vs. 15.5% for non-Virtual Ward group
- Patient satisfaction was excellent
- 83% of patients agreed that going home sooner from hospital aided their recovery
- 85% of patients agreed that they felt safe as a patient in the Virtual Hospital
- 88% of patients agreed that the frequency of contact and communication by the monitoring hub was about right.
Key success factors for implementation
- Robust technology – Hospital grade technology that is both compliant and from a recognised and trusted provider, is a key driver to overcoming the potential barrier of both Clinician and patient acceptability. Due consideration should be given to the user experience and journey so to empower the patient and Clinician.
- Clear methodology – As with any large clinical transformation which involves adoption of new technology, a clear plan that reflects a comprehensive understanding of the problem to be addressed is crucial. This includes identifying the appropriate use case and patient cohort.
- Pilot approach – Avoid a ‘big bang’ approach. We recommend phasing Virtual Wards in, targeting two or three patient cohorts of highest priority / acceptability first.
How can we help you?
Masimo SafetyNet® is a Digital Health platform from Masimo, whose innovative monitoring products have been in use across the NHS for over 15 years, with a proven track record of success.
Key features of Masimo SafetyNet® include:
- Continuous and spot check sensors to monitor patient vital signs remotely via Bluetooth connectivity in real-time
- Over 150 live Customisable care programs, including training and educational material
- Secure NHS NDG compliant network via AWS cloud, enabling 24/7 two-way audio and video communications with the capability for EMR integration
- Dynamic dashboard and customisable alert limits to automatically notify and inform Clinicians as required
Masimo has a vision to support healthcare providers deliver effective and safe patient care from the comfort a patient’s home through hospital grade technology-enabled Virtual Wards. To support providers in rapidly implementing Virtual Wards, Masimo in partnership with Akeso have developed a suite of documents to achieve their goals, whilst ensuring quality patient care.
