Researchers from the University of Southampton IT Innovation Centre secured a significant MHX project with North and Mid Hants Integrated Care Partnership and the Wessex Academic Health Sciences Network in a bid to deploy and scaleup a remote patient monitoring system with a focus on pulse oximetry for the southeast region of England. More specifically, the oxygen levels of COVID-19 patients will be remotely monitored in what is being called a new “virtual ward” program driven by the computer science talents of computer scientists of University of Southampton (“Soton”). With this advancing technology in place, health professionals can better identify patient deterioration early on involving COVID-19 patients, enabling more timely and appropriate intervention, including escalation to higher levels of acute care through hospital admissions. The unfolding digital health movement has been turbocharged by COVID-19 and the NHSx is funding initiatives to increase digitization for advancements in care, and protection of patients and staff during the pandemic.
NHS will be ‘Digitized’
As health care in systems from the United States to the UK become more costly and complicated, the wave of digitization, made possible due to a confluence of forces form cheap pervasive cloud computing to smart phones and an accumulation of sophisticated apps and “digital health” programs to advances in precision-based medicine. All converge for an ongoing and continuous disruption: those health systems that don’t understand, embrace and employ will get left behind. Much like telehealth, remote patient monitoring represents a segment in the emerging digital health space. It should be noted for the TrialSite reader that research must and will unfold alongside the clinic. At the center of all of this is the connectivity, and in theory the comfort and support, of the patient.
The NHS, the venerable British national health system too acknowledges its time to incrementally go with the flow of technological change. The latest announcement form the University of Southampton is one such example of this trend, which COVID-19 turbocharges. The NHS will embrace and employ digital remote monitoring to not only reduce infection SARS-CoV-2 infection rates by greatly reducing physical contact but also introduce more precision and patient-centric ways of delivering emergency care.
Introducing Remote Community Oximetry Care (RECOxCARE)
RECOxCARE exemplifies this new reality. Powered by the University of Southampton technical talent and innovation, the system should provide a method for clinicians to remotely monitor patients at home, precluding the necessity of as many patient visits.
RECOxCARE also supports the rapid follow up of patients post hospital discharge, particularly for those frail, elderly and vulnerable patients with multiple long-term conditions at high risk of adverse complication events and re-admission to the hospital, reported Soton recently in its press release.
Part of COVID-19 Care Management
As it turns out, COVID-19 implicates that some patients will suffer from silent hypoxia, that is where oxygen levels ascend to dangerously low levels less the observable, and noticeable difficulties with breathing. Dr. Matt Inada-Kim, National Clinical Lead Deterioration & National Specialist Advisor Sepsis, NHS England and NHS Improvement, and Emergency Consultant at Hampshire Hospitals Foundation Trust observed that the NHS learned during the first wave of COVID-19 infections that many patients showed up at the hospital in serious condition, that is worse than they should given the symptoms. With RECOxCARE’s aim of empowering patients with home-based oximetry enabling physicians to identify trouble earlier and hence initiate escalations to reduce the risk of death from COVID-19.
Point of View from the IT Innovation Centre at Soton
Although seemingly simple and straightforward, this digital health-based remote patient monitoring solution combines and integrates observational data into safe clinical processes but there is a whole lot of technical and process problem solving because in all reality across different primary and secondary clinical context arises significant challenges of interoperability and timely access to data needed for direct care indicated Professor Michael Boniface, Director of the University of Southampton IT Innovation Centre. The professor also happens to lead the RECOxCARE digital work stream so he is actually a very important figure in the world of digital health-based remote patient monitoring. To pull a project like this off—the types of talent, processes, regulatory and legal issues and the costs—undoubtedly, Mr. Boniface has done some rapid learning.
More Holistic Comprehension of the COVID-19 Disease Life Cycle
Ultimately, healthcare systems and researchers want to better understand this new virus and associated disease lifecycle, from onset of infections and symptoms. Thus far, researchers and clinicians suspect, for example, COVID-19 has four phases, including 1) Incubation, 2) Symptomatic, 3) Early Pulmonary Phase, and 4) Immune Dysregulation. Of course, not everyone experiences all these phases while many are even asymptomatic.
But the key with digital monitoring of oximetry and other risk factors over the disease lifecycle clinicians and researchers shall gain a far greater understanding of COVID-19; a consequence of this accumulation of information will be the translation to improved clinical models. And in this spirit, University of Southampton participates in the Wessex ARC PPDRCOM Project (Predicting Patient Deterioration in Communities) which investigates how predictive analytics methods can be utilized to improve the ability to detect the most at risk patients in different care settings. This can be sought of moving to risk based care which represents more efficiency and effectiveness leading to a win-win for all involved.
This research has been funded by the NHSX as part of a South East Regional scale program to support patients at home through report monitoring. NHSX is a joint unit bringing together teams from the Department of Health and Social Care and NHS England and NHS improvement to drive the digital transformation of care.
Michael Boniface, CEng MIET, Professor, Director of the University of Southampton IT Innovation Centre