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Living with COVID-19 in a post-pandemic world
QCS’s Barry Price, a consultant who has worked in the care sector for over 15 years, says that the combination of new antiviral drugs and remote monitoring technology could be a game-changer for the treatment of COVID-19 in both domiciliary, supported living and residential care settings, provided the right policies and procedures are in place.
“Our ability to contain and control COVID-19 has improved dramatically in recent months. This has largely been due to immunisation along with new anti-viral treatments, which the drug companies say significantly reduces the risk of hospitalisation for vulnerable adults. Another breakthrough is that patients taking these drugs can be monitored remotely from their homes thanks to new technology in the form of mobile apps.
I caught COVID-19 at the end of January. It really opened my eyes into not only how effective the new antiviral treatments are. But also, how the application of monitoring technology enables people like me to stay at home when they have health issues.
The NHS is now offering new antibody and antiviral treatments to people with coronavirus who are at highest risk of becoming seriously ill. I take a biological medication for chronic psoriasis, an auto-immune condition – and I’m therefore considered at risk.
When I experienced breathing issues, I was referred to my local NHS coronavirus team (who had already informed me I was eligible for the antivirals) who offered me an appointment at the hospital. I was expecting to be administered pills, but I was given the medication by infusion and then monitored for any side effects. Apparently, this is 85% effective in keeping patients out of hospital, as opposed to taking it in tablet form, which is around 37%.
Once I had received the treatment, I was given a monitoring pack to allow me to recuperate at home. This involved downloading an app and a SATS monitor to measure oxygen levels. The app was not difficult to use, was easy to install and to navigate. With it I recorded my symptoms and helped clinicians at the hospital track my condition – if it deteriorated, I would be re-assessed.
There was a ‘virtual ward’ at the hospital where the COVID-19 team worked. At one point, I got a call from them as my SATS level was low and it flagged up on their dashboard. After a telephone consultation, it was agreed that there wasn’t a serious issue.
In addition, every day for six days I received calls from the hospital team to ask me if I was experiencing any side effects from the medication, to discuss my remote stats and a general how are you doing call. So although I was at home, I was made to feel safe as I was connected to healthcare professionals.
To access the new technology, patients require access to a personal smartphone (Apple or Android) to run the mobile app. The clinical team involved in observing the data and initiating follow-up consultations need a suitable laptop or desktop with an active internet connection.
Home care likely to increase
The benefits of the system are that it contains the spread of the virus by keeping those with symptoms and those who are high risk at home. (It is highly likely that without the anti-virals I would have previously ended up in hospital.) And hospitals can now monitor many people in the community remotely, which of course will free up much-needed beds.
What’s important when it comes to treating people at home under this new way of working is that domiciliary care and support workers will require a set of new policies and procedures to help them manage the change.
Following my experience, I started to research the different apps available. They aren’t just for COVID-19, but for many other conditions that are suitable for remote monitoring – from diabetes to heart conditions.
This explosion of viable technology alleviates operational pressures on the NHS. If people are being treated at home, the NHS might see reduced pressure on staffing numbers. If there are a significantly lower number of patients on a ward, the question some might ask is do we still need wards?
Of course, the answer is ‘yes’, but it could mean in the future that new technologies will enable us to have the conversation and provide a wider range of treatment options. Even if more people are treated at home there will still be clinical staff required to review and monitor remote support.
Of course, with any new technology and its application, it throws up a serious dilemma for health providers. Staff will have to be trained as to how to use the applications – and how to upload the results such as SATS levels. Patients also will need to be trained on how to use the system. And there will have to be procedures in place if something goes wrong, such as false readings or monitors not working.
Although remote monitoring will take the pressure off the NHS, that pressure is likely to be felt elsewhere. There will definitely be a knock-on effect on social care in the community. This is where QCS can help. Its range of policies and guidelines include training plans with needs analysis for new technology adoption, as well as care plans for individuals which would include medication schedules and other important health monitoring information.
If more people are being cared for at home, where will the additional resources needed to manage this come from? Of course, if a person is completely independent, as I am, then that’s not generally going to be an issue. But if a person presents with additional health issues and needs a carer to check in on them regularly, and perhaps to help with the remote care, staffing issues come into play again.
As well as additional training costs, Data Protection requirements and UK GDPR regulations will have to be considered as personal information is stored on a digital platform. Guidelines on how providers and staff share information and communicate with hospitals ‑ and how to foster this new joint working ‑ will also need to be drawn up.
So there will need to be new policies and procedures in place to manage this fundamental change in how advancements and remote monitoring in health care is delivered. But I am hugely optimistic that it is an important development that will positively impact many people and allow them to stay where they want to be – which is at home.
QCS policies and guidelines:
- COVID-19 HUB
- Training plans with needs analysis for new technology
- Care plans
- Cooperating with other providers
The article was first published on The Carer
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