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Pushing for a broader virtual care rollout – what has the UK learned?

18 Dec 2023, by Amy Sarcevic

The National Health Service (NHS) in England is ramping up its use of virtual care, striving for 40-50 virtual ward ‘beds’ per 100,000 people, and more than 50,000 virtual admissions each month.

To date, this rollout has been well-received by the UK public, with 71 percent claiming they are open to the idea of being treated in a virtual ward.

While the statistics may be encouraging, progress towards a more ubiquitous virtual health sector rests on several key factors, according to Dr Sarah Robinson, Director of Delivery at Health Innovation East – part of England’s Health Innovation Network.

Ahead of her keynote at the National Telehealth Conference, Dr Robinson discusses these factors, sharing insights from the Health Innovation Network.

Implementation and workforce considerations

Amidst the excitement of new virtual care tools which promise to streamline workflows and improve outcomes in the physical and mental health space, comes an equal measure of consideration. Among the greatest points of focus is the issue of accountability, Dr Robinson said.

“There is a fair amount of discussion around where accountability lies when a patient is being treated in the community instead of within a hospital. If someone’s health were to deteriorate, or an issue to occur with the technology, who is accountable for picking this up? The GP, the nurse delivering care under that pathway, or the technology provider?”

The concerns increase when you consider the challenges of delivering care via technology, she added.

“Not all staff are as comfortable with digital technology as others. Even among those who are, do we really understand how it feels in terms of job satisfaction when you are only seeing the output from a device and not the patient in person.”

Equity of Access considerations

While equity of access is not a surprising issue to emerge in an analysis of virtual care, the nature of inequity has been of interest, Dr Robinson said.

“There is a broad assumption that it is older adults that struggle to access virtual care, but the research has revealed greater layers of complexity.

“Of course, there are obvious factors involved, like people not having the technical skills. But there are also issues around people’s home environments.

“For example, people with caring responsibilities might fare better in a hospital, rather than being thrust back into their home, where they feel they have to juggle caring responsibilities instead of resting.”

The UK’s cost of living crisis and standard of housing has also created challenges for the virtual care system.

“We hear of people that can’t afford to keep their houses heated and in the midst of a cold winter, jeopardising their ability to get well again. This has emerged as a particular issue in respiratory care pathways – and it’s not an issue we can easily solve in the UK within the current benefits system.”

Industry collaboration and interoperability

While interoperability is a hot topic in the realm of virtual care, Dr Robinson believes it needs more airtime amongst innovators, along with a greater focus on collaboration.

“Technology adoption is often viewed through a black and white lens. We tend to think of new innovations as being in competition with each other. In part, that is true, because they each want to secure a segment of the market. But what works out well is if innovators, who aren’t commercially linked, can work together and cater to different elements of the care pathway or population.”

Dr Robinson shares the example of FibriCheck, an innovative, hardware-free smartphone and smartwatch application that detects cardiac arrhythmias using the phone’s camera. The technology was designed in partnership ZioXT Patch, a wire-free remote ECG monitor. Data from the monitor is analysed by AI technology and validated by a team of cardiac physiologists.

Talking more about these technologies – and the transition to virtual care more broadly – Dr Sarah Robinson will deliver an international keynote at the upcoming National Telehealth Conference.

The conference will be held 7-8 March 2024 at the Hilton Sydney, as part of the flagship Connect Virtual Care event.

Co-located at the event are two additional conferences: Hospital in the Home 2024 and Medication Safety & Efficacy 2024.

Learn more and register your place here.

About Dr Sarah Robinson

Sarah oversees the delivery of Health Innovation East’s programme of work from NHS England. This involves the delivery of real-world evaluations and a range of contracted activity from health and care partners. Health Innovation East is the innovation arm of the NHS in the East of England. Its multidisciplinary team of experts helps the best innovations in health and care reach the people, places and problems where they bring most benefit.

Sarah is also appointed to the Implementation Lead role for the NIHR East of England Applied Research Collaborations (ARC) and works with partners in both the ARC and the Health Innovation Network to support the implementation of promising applied health and care research.

Sarah works closely with the National Wound Care Strategy Programme, on behalf of the Health Innovation Network, on implementing, testing and evaluating lower limb pathway recommendations. This comprises of scaling real-world evaluation across 8 sites in England.

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