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Cited by 160Telemedicine and Telehealth ImplementationCOVID-19 Clinical Research StudiesHealthcare during COVID-19 Pandemic

Remote home monitoring (virtual wards) for confirmed or suspected COVID-19 patients: a rapid systematic review

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Vindrola-Padros, Cecilia, Singh, Kelly E, Sidhu, Manbinder S, Georghiou, Theo, Sherlaw-Johnson, Chris, Tomini, Sonila M, Inada-Kim, Matthew, Kirkham, Karen +3 more·2021·eClinicalMedicine
DOI 10.1016/j.eclinm.2021.100965PMC PMC8219406

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Abstract

ABSTRACT Objectives The aim of this review was to analyse the implementation and impact of remote home monitoring models (virtual wards) during COVID-19, identifying their main components, processes of implementation, target patient populations, impact on outcomes, costs and lessons learnt. Design A rapid systematic review to capture an evolving evidence base. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Setting The review included models led by primary and secondary care across seven countries. Participants 27 articles were included in the review. Main outcome measures Impact of remote home monitoring on virtual length of stay, escalation, emergency department attendance/reattendance, admission/readmission and mortality. Results The aim of the models was to maintain patients safe in the right 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/carer 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 standardised 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. Conclusions 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. Protocol registration The review protocol was published on PROSPERO (CRD: 42020202888). RESEARCH IN CONTEXT Evidence before this study Remote home monitoring models for other conditions have been studied, but their adaptation to monitor COVID-19 patients and the analysis of their implementation constitute gaps in research. Added value of this study The review covers a wide range of remote home monitoring models (pre-hospital as well as step-down wards) implemented in primary and secondary care sectors in eight countries and focuses on their implementation and impact on outcomes (including costs). Implications of all the available evidence The review provides a rapid overview of an emerging evidence base that can be used to inform changes in policy and practice regarding the home monitoring of patients during COVID-19. 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.

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Authors
Vindrola-Padros, C., Singh, K. E., Sidhu, M. S., Georghiou, T., Sherlaw-Johnson, C., Tomini, S. M., Inada-Kim, M., Kirkham, K., Streetly, A., Cohen, N., & Fulop, N. J.
Affiliations
  • University of Birmingham (GB)
  • Nuffield Trust (GB)
  • University College London (GB)
  • Royal Hampshire County Hospital (GB)
  • King's College London (GB)
ORCID
Venue
eClinicalMedicine
Publisher
Elsevier BV
Published
2021-07
Volume
37
Pages
100965
ISSN
2589-5370 (ISSN-L)
DOI
10.1016/j.eclinm.2021.100965
PMC
PMC8219406
OpenAlex
W3169549100
Cited by
160
References
4
Citations by year
2026: 15 · 2025: 26 · 2024: 31 · 2023: 36 · 2022: 38 · 2021: 12 · 2020: 2
FWCI
5.15
Type
journal article
Language
en
Open access
Licence
Locations
  • EClinicalMedicine (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
Funders
National Institute for Health Research (HSDR16/138/31)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Physical Sciences › Computer Science › Information Systems › Healthcare during COVID-19 Pandemic
Keywords
COVID-19 pandemic, remote home monitoring, virtual wards, telemedicine, secondary care, primary care, hospital readmission, emergency department visits, mortality, telephone monitoring, wearable sensors, patient safety, implementation, cost-effectiveness, risk stratification

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