Huma: Medopad, evaluation of the remote digital care platform
Report produced by Kent Surrey Sussex Academic Health Science Network and NHSX
Huma: Medopad
Evaluation of the remote digital care platform
Context
COVID-19
Coronavirus disease is a novel severe acute respiratory infection.
Regular monitoring and early detection of symptom changes can enable timely care for deteriorating patients.
Remote digital care
Outlined in the NHS Long Term Plan, the facilitate of remote digital care has been accelerated by COVID-19.
Dedicated GP-led Hot Hubs provide face to face (F2F) consultations where needed, but offer virtual wards for patients who require further observation but can be monitored from home.
The Solution
Huma created a remote patient monitoring smartphone app and clinician portal, Medopad, for patients with suspected or confirmed COVID-19.
Medopad
Medopad enables patients to record their symptoms and physiological parameters such as:
- heart rate
- blood pressure
- oxygen saturation
- body temperature
Benefits
Tracking symptoms and monitoring disease progression supports the early identification of patients at risk of deterioration. This can provide opportunities for earlier interventions.
Purpose of evaluation
- Assess the potential impact of Medopad relative to the COVID-19 remote care pathway.
- Highlight recommendations for improvement, and limitations in the process.
- Determine whether the evidence from this evaluation supports the wider scaling of this solution.
- Determine whether this solution is going to benefit the healthcare system.
Pilot sites
Main pilot sites
Primary care
North West London (NWL) CCGs' Hot Hubs:
Central London CCG
Hillingdon CCG
Secondary care
West Hertfordshire Hospitals NHS Trust (WHHT):
Watford Hospital
Approach
Data was collected between April - July 2020 using a mixed methods approach:
- Research and literature review
- Quantitative analysis
- Surveys with the NWL Hot Hubs
- Interviews with patients and clinicians
- Exploratory analysis on potential benefits
Key Findings
This evaluation sought to answer two core questions:
What is the solution’s impact and is it going to benefit the healthcare system?
- High level of patient satisfaction and compliance
- No adverse health outcomes
- Inconclusive results regarding impact on staff workload
- Small sample size and inconsistent data
- Unable to derive clear health economic outcomes
Does the evidence support the wider scaling of this solution?
- Credible solution for remote monitoring
- Some evidence of value and efficacy
- Further validation of findings required to ensure confidence
- Need to measure resource requirements
- Recommend close oversight and further evaluation
Outcomes
Workload capacity and efficiency
- 3 minutes average time saved per hot-hub patient per day
- 32 minutes average time saved per patient in WHHT
- 5% 28 day readmission rate for Medopad patients
- 8% 28 day readmission rate for non-Medopad patients
Patient outcomes
Patient recovery rates within primary care:
- 87% non-Medopad patients
- 100% Medopad patients
Physical follow-ups
Data suggested a slight increase in Av. number of clinical follow-ups:
- 7.33 non-Medopad patients
- 8.68 Medopad patients
Patient experience
Key findings
Responses from 30 patients found:
Usability
95% of respondents felt the app was easy to use.
Acceptability
- 76% of respondents felt happy to use this form of care again.
- +71 Patient group Net Promoter Score*
"Reassuring" was the most common word selected to describe the app (from 8 options).
Patient experience
- 93% rated Medopad as 'good' or 'very good' for care.
- Ease of recording data within the app.
- Visual reassurance that a GP had viewed the data.
- Interviewees felt Medopad was quicker, more flexible, and allowed for constant monitoring without having to be in hospital.
Patient testimonials
Reassurance
“It was an easy app to use, which allowed me to maintain daily contact with the nurses and doctors. I always got a call back when unwell to review my condition which I found very containing during an anxiety provoking time.”
“I could see, for myself, symptoms worsening or improving, which stopped me worrying and I felt in control”
“It gave me a peace of mind to see that I was monitoring especially when the oxygen level was dropping and [...] they called quickly to check on me”
Clinician experience
Key findings
Responses from 12 clinicians found:
Usability
- 56% felt the dashboard was easy to review patient data.
- 58% felt remote monitoring with Medopad was more time effective.
- Suggested time saving through using Medopad.
Acceptability
- 6.9 average score out of 10 for confidence in using the platform to support care.
- -25 Staff group Net Promoter Score*
*Net Promoter Score rates the likelihood of a group recommending a product
Further feedback
Through the survey and supporting interviews, patients spoke glowingly of the care provided by the clinical teams.
"I am in awe of such handling of patients."
“Super quick and efficient with their responses. Felt they dedicated a lot of time and attention to me and I was not left hanging. Couldn’t praise them higher. Doctors were lovely and frequently called to check on me.”
Clinical feedback was less effusive, while multiple interviewees stated that Medopad had helped them make decisions quickly, others mentioned that it may create additional work through the reporting of false positives.
“Some patients also were recording worrying symptoms but when you spoke to them on the phone they were fine. [Medopad] created more calls and work”
“Escalating to secondary care earlier.”
"More proactive care"
Limitations
Limited and unavailable data
Challenges in collecting consistent datasets
Governance challenges
Lack of clear governance structure despite best efforts from all parties
Pilot study population
Cohort segmentation hindered ability to draw certain conclusions
COVID-19 variance
Varying daily cases and mortality rates across England over time may affect outcomes seen in different sites
Inclusive access to the Solution
Further research is required to understand the outcomes of Medopad across different demographic populations
Recommendations
Build robust evidence for value and effectiveness, including health economic modelling.
Monitor and review Medopad across further pilot sites in future evaluations.
Develop clear measurement strategies and commercial development to support sustainability.
Consider improvements to the user experience design and process.