Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review
Background: the aim of this review was to analyze the implementation and impact of remote home monitoring models (virtual wards) for confirmed or suspected COVID-19 patients, identifying their main components, processes of implementation, target patient populations, impact on outcomes, costs and les...
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2021-07-01
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doaj-8fb9a9d3bdf24a6e9ddff0c2a37857e52021-07-29T04:23:31ZengElsevierEClinicalMedicine2589-53702021-07-0137100965Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic reviewCecilia Vindrola-Padros0Kelly E Singh1Manbinder S Sidhu2Theo Georghiou3Chris Sherlaw-Johnson4Sonila M Tomini5Matthew Inada-Kim6Karen Kirkham7Allison Streetly8Nathan Cohen9Naomi J Fulop10Department of Targeted Intervention, University College London (UCL), Charles Bell House, 43-45 Foley Street, London W1W 7TY, United Kingdom; Corresponding author.Health Services Management Centre, School of Social Policy, University of Birmingham, Park House, University of Birmingham, Edgbaston, Birmingham B15 2RT, UKHealth Services Management Centre, School of Social Policy, University of Birmingham, Park House, University of Birmingham, Edgbaston, Birmingham B15 2RT, UKNuffield Trust, 59 New Cavendish Street, London W1G 7LP, UKNuffield Trust, 59 New Cavendish Street, London W1G 7LP, UKDepartment of Applied Health Research, University College London, Gower Street London, WC1E 6BT, UKWessex Academic Health and Science Network, National COVID Clinical Reference groups- Primary care, Secondary care, Care homes, National Clinical Lead Deterioration and National Specialist Advisor Sepsis, NHS England and NHS Improvement, McGill ward, Royal Hampshire County Hospital, Romsey Road, Winchester SO21 1QW, UKIntegrated Care System Clinical Lead, NHSE/I Senior Medical Advisor Primary Care Transformation, Dorset CCG, Vespasian House, Barrack Rd, Dorchester DT1 7TG, UKDepartment of Population Health Sciences Faculty of Life Sciences and Medicine King's College London SE1 1UL, UK; Deputy National Lead Healthcare Public Health, Public Health England133-155 Waterloo Rd, London SE1 8UG, UKUniversity College London, UKDepartment of Applied Health Research, University College London, Gower Street London, WC1E 6BT, UKBackground: the aim of this review was to analyze the implementation and impact of remote home monitoring models (virtual wards) for confirmed or suspected COVID-19 patients, identifying their main components, processes of implementation, target patient populations, impact on outcomes, costs and lessons learnt. Methods: we carried out a rapid systematic review on models led by primary and secondary care across seven countries (US, Australia, Canada, The Netherlands, Ireland, China, UK). The main outcomes included in the review were: impact of remote home monitoring on virtual length of stay, escalation, emergency department attendance/reattendance, admission/readmission and mortality. The search was updated on February 2021. We used the PRISMA statement and the review was registered on PROSPERO (CRD: 42020202888). Findings: the review included 27 articles. The aim of the models was to maintain patients safe in the appropriate setting. Most models were led by secondary care and confirmation of COVID-19 was not required (in most cases). Monitoring was carried via online platforms, paper-based systems with telephone calls or (less frequently) through wearable sensors. Models based on phone calls were considered more inclusive. Patient/career training was identified as a determining factor of success. We could not reach substantive conclusions regarding patient safety and the identification of early deterioration due to lack of standardized reporting and missing data. Economic analysis was not reported for most of the models and did not go beyond reporting resources used and the amount spent per patient monitored. Interpretation: future research should focus on staff and patient experiences of care and inequalities in patients’ access to care. Attention needs to be paid to the cost-effectiveness of the models and their sustainability, evaluation of their impact on patient outcomes by using comparators, and the use of risk-stratification tools.http://www.sciencedirect.com/science/article/pii/S2589537021002455Remote home monitoringVirtual wardsCOVID-19SARS-CoV-2Silent hypoxiaRapid systematic review |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Cecilia Vindrola-Padros Kelly E Singh Manbinder S Sidhu Theo Georghiou Chris Sherlaw-Johnson Sonila M Tomini Matthew Inada-Kim Karen Kirkham Allison Streetly Nathan Cohen Naomi J Fulop |
spellingShingle |
Cecilia Vindrola-Padros Kelly E Singh Manbinder S Sidhu Theo Georghiou Chris Sherlaw-Johnson Sonila M Tomini Matthew Inada-Kim Karen Kirkham Allison Streetly Nathan Cohen Naomi J Fulop Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review EClinicalMedicine Remote home monitoring Virtual wards COVID-19 SARS-CoV-2 Silent hypoxia Rapid systematic review |
author_facet |
Cecilia Vindrola-Padros Kelly E Singh Manbinder S Sidhu Theo Georghiou Chris Sherlaw-Johnson Sonila M Tomini Matthew Inada-Kim Karen Kirkham Allison Streetly Nathan Cohen Naomi J Fulop |
author_sort |
Cecilia Vindrola-Padros |
title |
Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review |
title_short |
Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review |
title_full |
Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review |
title_fullStr |
Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review |
title_full_unstemmed |
Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review |
title_sort |
remote home monitoring (virtual wards) for confirmed or suspected covid-19 patients: a rapid systematic review |
publisher |
Elsevier |
series |
EClinicalMedicine |
issn |
2589-5370 |
publishDate |
2021-07-01 |
description |
Background: the aim of this review was to analyze the implementation and impact of remote home monitoring models (virtual wards) for confirmed or suspected COVID-19 patients, identifying their main components, processes of implementation, target patient populations, impact on outcomes, costs and lessons learnt. Methods: we carried out a rapid systematic review on models led by primary and secondary care across seven countries (US, Australia, Canada, The Netherlands, Ireland, China, UK). The main outcomes included in the review were: impact of remote home monitoring on virtual length of stay, escalation, emergency department attendance/reattendance, admission/readmission and mortality. The search was updated on February 2021. We used the PRISMA statement and the review was registered on PROSPERO (CRD: 42020202888). Findings: the review included 27 articles. The aim of the models was to maintain patients safe in the appropriate setting. Most models were led by secondary care and confirmation of COVID-19 was not required (in most cases). Monitoring was carried via online platforms, paper-based systems with telephone calls or (less frequently) through wearable sensors. Models based on phone calls were considered more inclusive. Patient/career training was identified as a determining factor of success. We could not reach substantive conclusions regarding patient safety and the identification of early deterioration due to lack of standardized reporting and missing data. Economic analysis was not reported for most of the models and did not go beyond reporting resources used and the amount spent per patient monitored. Interpretation: future research should focus on staff and patient experiences of care and inequalities in patients’ access to care. Attention needs to be paid to the cost-effectiveness of the models and their sustainability, evaluation of their impact on patient outcomes by using comparators, and the use of risk-stratification tools. |
topic |
Remote home monitoring Virtual wards COVID-19 SARS-CoV-2 Silent hypoxia Rapid systematic review |
url |
http://www.sciencedirect.com/science/article/pii/S2589537021002455 |
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