Watford General treated hundreds of Covid-19 patients in virtual hospital

Medics from Watford General have been treating hundreds of Covid-19 patients in their own homes, after setting-up a ground-breaking ‘virtual hospital’.

Wednesday, 8th July 2020, 9:34 am
Updated Wednesday, 8th July 2020, 9:38 am

Many of the patients have been referred directly to the ‘virtual hospital’ from accident and emergency, hospital consultants or GPs.

And others have been discharged to the ‘virtual hospital’, rather than being kept on traditional hospital wards for longer.

Patients ‘admitted’ to the ‘virtual hospital’ submit their own pulse and oxygen saturation readings throughout the day, while remaining in their own homes.

Warford General Hospital

They are monitored virtually by hospital medics – some of whom cannot work on the front-line during the pandemic, because of their own health.

And instead of traditional ward rounds doctors speak to their patients by phone or video conference.

The virtual model was devised by divisional director for medicine Dr Andrew Barlow and respiratory consultant Dr Matthew Knight in March, amid concerns about the impact Covid-19 could have on the hospital.

And since then it’s supported the care of more than 1200 patients with Covid-19 symptoms.

Early estimates suggest that in its first 21 days of operation alone it had saved 290 bed-days at the hospital – equivalent to 14 beds at any one time.

And it’s already been copied by other hospitals too.

The success of the virtual model was out-lined to the board of the West Hertfordshire Hospitals Trust – which runs Watford General, St Albans City and Hemel Hempstead hospitals – on Thursday (July 2) by Dr Barlow.

According to Dr Barlow, patients are reviewed by a respiratory consultant on the day they are referred to the ‘virtual hospital’.

Those deemed to be low risk are reviewed after seven and 14 days – and prompted to get in touch if their symptoms change.

But those ‘high risk’ patients – who may be over-50, have additional health needs, have symptoms that are ‘out of proportion’ or who are health care workers – are monitored several times a day.

They are issued with pulse and oxygen monitors and submit their data from home – visiting the the hospital for chest x-rays, blood tests or re-admission, if required.

Following the board meeting, respiratory consultant Dr Knight told the Local Democracy Reporting Service they came up with the idea for the virtual hospital, after seeing how hospitals in other parts of the world were being overwhelmed.

At that stage he said they had no idea how many patients would need to be admitted to hospital.

But he said they knew that the virtual hospital would conserve space in the hospital for those who really needed it.

In practice, he says, it also reduced the amount of personal protective equipment (PPE) that would have been needed to care for the patients in the hospital face to face.

And, he says, it was better for those patients who preferred to be in the familiar environment of their own homes, but wanted to know they were safe.

“It kept patients out of hospital in their own homes , which was a relaxed and safe environment,” said Dr Knight.

“There were people who didn’t feel hospital was a safe place to be – they wanted to be at home, but they wanted to know they were safe.

“And we were providing consultant level care to every patient.”

Dr Knight says patients found the regular phone calls reassuring – with clinicians spending most of each day in direct contact with patients.

Initially consultants and other staff from the virtual hospital would phone patients to collect data and ask targeted questions.

But now there is also the option of an ‘app’ allowing patients to submit data electronically too – with messages going back to patients once the data has been looked at.

At the meeting Mr Barlow told the board that since the middle of March 1,272 patients had been referred to the virtual hospital and more than 9.000 calls had been made.

Only 414 of those patients had confirmed Covid-19, he said. Eighteen of the patients referred to the service died.

For the future Dr Barlow says the Trust is looking at the use of a wearable device that transmits oxygen saturation, pulse and respiratory readings every minute for closer monitoring.

And Dr Knight says in future the technology could be rolled out to out-patient appointments too.

He estimates that between a third and a half of out-patient appointments could be done online – and that there are patients who would prefer not to have to come in to hospital.

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