Acutely unwell patients receiving care from the Oxford University Hospital (OUH) acute hospital-at-home services Signs and Symptoms
Conditions
Interventions
Participants will be provided with the VIABLE monitoring system which consists of an adhesive chest patch that will collect vital signs data (e.g. heart rate), and a pulse oximeter
both devices relay data continuously to a tablet computer that transfers data to a clinician's dashboard. Participants will also be provided with a blood pressure monitor and an in-ear thermometer and
Sponsors
University of Oxford
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: 1. The AAU clinical team has determined it is clinically appropriate to manage the patient at home and the patient will be admitted to the Hospital at Home virtual ward 2. Acutely ill (a deterioration in health that has taken place over days or weeks) and assessed as requiring diagnostic tests and treatments including the following interventions (oxygen, fluids, diuretics, intravenous antibiotics) that can be delivered at home. 3. Assessed as having at least one of the following diagnoses (multiple acute problems may present together): 3.1. Lowerrespiratorytractinfection 3.2. Cellulitis 3.3. Urinary tract infection 3.4. Systemic evidence of acute infection but unclear primary source of infection 3.5. Acute Kidney Injury due to dehydration, infection, medication, or heart failure 3.6. Heart failure with acute fluid overload 4. Willing and able to go home with a skin contact vital-sign monitoring system (chest patch) 5. Resides within the area served by an acute hospital at-home service 6. Participant is EITHER: 6.1. Willing and able to give informed consent for participation in the study, OR 6.2. Favourable consultee advice is provided for those lacking capacity 7. Male or Female aged 18 years or above
Exclusion criteria
Exclusion criteria: 1. The research team is not satisfied that remote monitoring can be safely established in the patient’s home 2. Pregnancy 3. Unable to comply with the study procedures 4. The mobile phone network at the patient’s residence is unsuitable for safe and effective monitoring
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Feasibility of continuous remote vital-sign monitoring measured using data coverage (data received remotely on each day of virtual ward care) including reliable heart rate in any 4-hour sliding window and reliable blood oxygen level (SpO2) received in any 12-hour sliding window over the monitoring period. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. To test the acceptability of remote vital-sign monitoring participants will be asked to complete a Technology Assessment Questionnaire 1 - 4 weeks after the end of monitoring 2. To determine the feasibility of intermittent blood pressure and temperature monitoring, the proportion of individuals able to place monitors, activate measurements and then provide data during the monitoring period will be analysed. 3. Collect clinical data using the VIABLE system over the course of the monitoring period to determine the optimal combination of vital sign data and frequency of review required to monitor acute virtual ward patients remotely. 4. Collect clinical data using the VIABLE system over the course of the monitoring period to refine threshold limits for safety, changes in clinical treatment and prioritisation for review as presented on the clinical dashboard. 5. Collect clinical data from the Oxford University Hospital (OUH) Clinical Data Warehouse approximately 6 months after the end of the monitoring period to develop clinically appropriate outcome measures for further evaluation. 6. Collect clinical data from the OUH Clinical Data Warehouse approximately 6 months after the end of the monitoring period to link to vital-sign data to demonstrate the feasibility of data linkage for refining clinical prediction rules. | — |
Countries
England, United Kingdom
Contacts
Public ContactAndrew Farmer
Outcome results
None listed