Scotland’s remote health pathway for people with COVID-19 symptoms improved access to NHS services and can be safely rolled out to help others, an evaluation has found. 

The study also found that patients had positive experiences of using the system, which was built using Inhealthcare’s technology, and staff felt supported and engaged. 

The evaluation indicated the remote health pathway contributed to increased self-management among patients, improved resource efficiency and reduced health inequalities with more than twice as many people from disadvantaged areas using the system. 

The research focused on a cohort of 149 patients and was based on analysis of submitted readings, patient interviews and staff surveys.

A clinical advisory group of experts from general practice, infectious diseases, respiratory medicine, intensive care, emergency medicine, the Scottish Ambulance Service and NHS24 designed the pathway to detect and manage early deterioration among COVID-19 patients. 

The pathway went live in January 2021 and enabled patients who were below the threshold for hospital admission to self-monitor at home and respond to clinical questions via SMS text message, mobile app, web portal or traditional telephone landline. 

The Inhealthcare system allowed health boards to gather patient information about breathlessness, other COVID-19 symptoms, oxygen saturation and temperature. Any readings of concern triggered advice to call NHS services. 

A report by Dr Helen Alexander for Scottish Government’s Digital Health & Care Directorate, Technology Enabled Care Programme found the following outcomes:

• Improved access to services for those in greatest need with the most severe symptoms and lowest oxygen saturation levels 
• People had positive experiences of using the system, many felt reassured and most said they would be happy to use it again
• Staff felt engaged and supported, describing the system as “useful and easy to engage with” and most felt the trigger levels about right for patients.

The report also found indications the pathway contributed to: 

• Increased self-management as patients learned how to use a pulse oximeter for oxygen saturation levels and when to take action
• Effective and efficient use of time and resources for staff and patients 
• Reduced health inequalities with more than twice as many people from disadvantaged areas using the system than those from affluent areas. 

The report said: “The COVID-19 RHP [remote health pathway] improved access to services, those remotely monitoring their symptoms had positive experiences of using the system and staff felt engaged and supported. The COVID-19 RHP can be safely rolled out to others.”

Bryn Sage, chief executive of Inhealthcare, said: “Remote monitoring has become a very important tool for the NHS in supporting the many COVID patients who are below the threshold for hospital admission but at risk of deterioration. “Our technology has come of age during the pandemic and, as this evaluation shows, can be safely rolled out to help more people.

"The evaluation demonstrates how effective remote monitoring can be in reaching people living in disadvantaged areas. The use of inclusive technology like the traditional telephone landline can help overcome the digital divide.”

A separate peer-reviewed study of the same pathway led by Professor Brian McKinstry found that supported self-monitoring of patients with COVID-19 at home is reassuring to patients, acceptable to clinicians and can detect important signs of deterioration.