Auckland expands virtual wards

eHealthNews.nz: Digital Patient

Thursday, 22 February 2024

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NEWS - eHealthNews.nz editor Rebecca McBeth

Auckland’s hospital in the home (HITH) services have been expanded to prevent acute inpatient admissions and allow early discharge of patients with respiratory conditions, heart failure and cellulitis.

The northern region developed ‘hospital in the home’ (HITH) services during the Covid-19 pandemic, using technology to provide care to patients in their own homes.

In 2022, Counties Manukau monitored 120 Covid-19 patients safely at home and the hospital is now piloting remote patient monitoring (RPM) as an alternative acute care pathway to inpatient admissions. More than 170 patients have been through the new service.

Caroline Ogilvie, project manager at Te Whatu Ora Counties Manukau, spoke at Digital Health Week in November 2023 about the project which utilises a wearable chest patch to continuously monitor vital signs such as blood pressure, heart rate, respiratory rate, saturated oxygen, and skin temperature.

“We wanted to identify conditions normally managed as short inpatient stays that can be managed at home with the right technology,” Ogilvie said.

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Results from 101 patients in the first 6 weeks of the project showed more than a quarter of patients would not have been discharged without the home monitoring in place, saving 30 - 56 inpatient bed days and preventing the need for 87-146 home visits.

Seventeen percent of the patient cohort had a deterioration identified while wearing the chest patch and all avoided an ED presentation.

More than 80 percent of patients in the service are over 60 years-old and the ethnic profile is similar to that of those normally cared for in hospital.

Feedback revealed patients felt safe and well supported in their home and more than 80 percent had viewed their own data online.

“The interim results have been promising,” Ogilvie told conference attendees.

“We have shown that we can reduce the need for home visits and reduce the readmissions for our patients. As we go forward, we need to identify more specific use cases for continuous monitoring.”

The HITH service in Te Toka Tumai – Auckland involves care delivered in-person and via telehealth, and is being expanded to enable earlier discharge from hospital for medically stable patients.

In a presentation at Digital Health Week 2023, Rosica Latchman, nurse consultant - adult community service at Te Toka Tumai Auckland, said the aim of HITH was to shorten inpatient stays for those who do not need to be in hospital.

“What we learned from Covid-19 is this works well for our patients and for our hospital team,” she said.

In July 2022, Te Whatu Ora Te Toka Tumai Auckland rolled out some general medical pathways for heart failure and COPD and in early 2023 added a cellulitis pathway.

The team is looking at developing further pathways this year in areas such as diabetes, surgical and palliative care.

Co-presenter Lucy Westbrooke, clinical informatics MDT squad lead at Te Whatu Ora – Health NZ, said HITH is a new model of care that can release bed capacity and resources.

“Hospital in the home is a great way to be able to accelerate discharges out of the hospital: freeing capacity and bringing it to where the patients are more comfortable: in the home,” she said.