We talk to Adrian Flowerday, Managing Director here at Docobo about the need for Virtual Wards in the current climate and beyond, and the work Docobo have been doing in this area. 

Tell us about the need for Virtual Wards, Adrian?
As the NHS enters a post COVID recovery phase, there’s a real and urgent need for the NHS to free up hospital beds. NHSE guidance, with funding to support it, has been released that strongly encourages the formation and use of Virtual Wards, and systems will be accountable for the provision of this new way of working. Virtual Wards are an effective way of taking patient care out of the hospital, while enabling patients to be monitored once they have been discharged earlier from hospital and back in their own homes. Digital remote monitoring is the enabler that allows patient recorded data to be safely and securely collected and presented to hospital staff. To date, the focus has been on COVID Virtual wards, and that’s where we’ve been doing lots of our work since the beginning of the pandemic. However, with this early experience and development of operating procedures, we are now seeing the principle being applied to other clinical pathways, such as asthma, pneumonia and heart failure. It’s great to see that there is national recognition for the need for Virtual Wards and we’ve been working with Liverpool on these since early on in the pandemic.

We’ve been working on ways to keep people out of hospital and transforming hospital care for many years, in fact, since we created Docobo in 2001. Remote monitoring is a proven and efficient enabler to allow clinical teams to care for people at home, and we were well placed to support and roll out Virtual Wards when the need for them came at the start of the pandemic.

In the UK, remote monitoring has seen rapid growth and adoption, due in part to generous funding by NHSX, who have not only funded systems to adopt remote monitoring but have also been foundational in sharing best practice and supporting project implementation. They have also implemented the Digital Health Partnership Award to help NHS organisations in England bid for funding to speed up adoption of digital health and to support patients with long term conditions to remotely monitor their health at home or in the community with digital products.

We’re pleased to be part of the System C & Graphnet Care Alliance, which will provide our customers with game changing interoperability and patient identification through precision cohorting. Markus Bolton, joint CEO of System C & Director of Graphnet said in his predictions for 2022: ‘We expect to see a huge shift towards virtual wards and remote patient monitoring in homes and care homes to support people with long-term conditions as the NHS works towards preventing avoidable hospital admissions and providing better care at home.’

Can you talk us through what a Virtual Ward is?
Yes of course. Virtual Wards mean that patients are still under the care of a hospital but carry out intense monitoring (including blood oxygen levels and blood sugars levels etc) while at home. Data collected by patients in their own homes is fed back via a device such as our Docobo CAREPORTAL or via our App running on Android and iOS platforms. We collect both vital signs and – more importantly – symptoms.

For COVID Virtual Wards, daily virtual ward rounds on COVID patients at home are carried out by consultants, who assess patient observations including blood oxygen levels, blood pressure, ketones and blood sugars, among other measurements.

This intense monitoring picks up any deterioration in patients’ conditions, as these are flagged up, and appropriate medical care can be provided quickly and efficiently. It also means that when the patient’s condition improves, they can be ‘virtually’ discharged back to the primary care team, where they can continue to be monitored or discharged as appropriate.

Virtual Wards essentially free up hospital beds and means that patients can be monitored and cared for in their own homes.

What has Docobo done in the past with Virtual Wards?
We’ve worked with many of our clients across the UK to quickly and efficiently set up Virtual Wards across England. For example, in Liverpool we worked with Mersey Care NHS Foundation Trust, and Liverpool University Hospitals NHS Foundation Trust to set up COVID Virtual Wards. This project was really successful and we are now working on a Virtual Wards project with St Helen’s and Knowsley Hospital. Although this sounds like a new concept, this isn’t a new experience for us. Even back in 2008 we were collecting the same information at Glenfield Hospital, Leicester, where COPD patients were managed at home by the acute respiratory team, resulting in over 50% reductions in admissions and re-admissions.

What are you doing now with Virtual Wards?
We are working with many of our clients across England operating COVID virtual wards to ease the pressure on the NHS. In Coventry and Warwickshire, the ICS has really stepped up to the mark and now, all three acute hospitals have Virtual Wards. In Black Country ICS, we are just starting to see the expansion of Virtual Wards. We’re also working with other hospitals, using our remote monitoring expertise to ease the pressure on hospital beds and supporting patients in their own homes.

What do you see as the future of Virtual Wards?
The exciting thing about Virtual Wards, is that the possibilities are endless. Whereas the focus is currently on COVID Virtual Wards, there are no end of conditions that can be managed effectively from home, which will improve both outcomes for patients being treated in the comfort of their own home and avoid the need for countless trips to hospitals or clinics which could be avoided using remote monitoring. This really is a glimpse into the future, where seamlessly integrated care happens from home to hospital. Our collaborative work with the NHS has set us up to take this a lot further, which will include helping to manage the backlog of elective care as well.