The St. Antonius Hospital, together with e-health company Luscii, has developed home monitoring for hospitalised Covid patients. A reduction of 134 admission days was recorded in a group of 33 patients. These positive results bring a greater admission capacity for hospitals a step closer.
Home monitoring via the Luscii app
Covid-19 patients who have not yet fully recovered, but are stable, may voluntarily take early discharge. They receive home monitoring to ease the transition. Via a tailor-made program in the Luscii app, patients report their oxygen saturation levels, temperature and symptoms on a daily basis. A team of pulmonologists and co-assistants assess the data trends and make contact if necessary. In the case of deterioration, rapid adjustment of the treatment may prevent a readmission. The medical team is also available to patients by telephone for additional questions.
Reduction in length of stay
The results from the first Corona wave show a reduction of an average of 5 admission days per patient. This is based on 33 patients who were monitored at home during April and May. A large proportion of these patients received oxygen at home. This group experienced the greatest reduction, with an average of 6.5 admission days per patient. Three patients were readmitted without emergency. They, too, eventually recovered well.
A survey showed that 97% of patients were very satisfied with home monitoring. The remote monitoring provides a safe feeling. In addition, recovering in one’s own living environment is much more pleasant, with familiar faces close at hand. All users would recommend this form of care to their loved ones.
The home monitoring of St. Antonius Hospital was set up by a collaboration between Christiaan van Swol (chair of the e-health working group for Covid-19), pulmonologists Renske Vorselaars, Hans Hardeman and Eline Mattern, and Kalle Majoor and Agnes Grutters, both fifth-year co-assistants. Thanks to the earlier collaboration with Luscii for people with COPD, a creative solution for overcrowded hospitals could be devised quickly.
‘We saw the shortage of beds increasing and therefore wanted to create a nursing ward at home’, explained Agnes Grutters. ‘In a safe way, so that the hospital retains capacity without adding an extra burden onto GPs. As a requirement, patients had to be able to manage themselves at home. This home monitoring can actually be seen as a bridge between the hospital and the GP. Fortunately, we can include an unlimited number of patients at no extra cost. This flexibility is needed now that the number of admissions continues to rise’.
Expansion to other hospitals
Now that the second wave is in full swing, the St. Antonius Hospital is using the Luscii program once again. By now, almost 20 patients are already working with the app at home. By reducing admission days, more beds are available for Covid patients and regular care is less compromised. Several hospitals have already expressed an interest in using it, too. This can be achieved relatively quickly; the Maasstad Hospital and UMC Utrecht, for example, recently started as well. Approximately half of all Dutch hospitals already work with the Luscii app for other conditions.
Since 2017, pregnant women with an increased risk of complications can be monitored at home via SAFE@Home. This e-health program was developed by UMC Utrecht in collaboration with Luscii, a supplier of apps for remote care. Results of a pilot study show that this method of home monitoring leads to fewer clinic visits, fewer ultrasounds and fewer admissions among the participants. The program is now expanding further, with the Jeroen Bosch Hospital being the first to participate in the follow-up study.
In 2016, gynaecologist Dr. Mireille Bekker took the initiative in introducing this new method of monitoring. “I wanted to modernise care for pregnant women, so they would only have to visit the hospital if it was really necessary. That’s how I came up with SAFE@Home”. In Luscii, she found a partner who had the innovative technology readily available and a successful collaboration was set in motion.
In the app, women can measure their blood pressure at home and fill in a questionnaire. This data is forwarded to the hospital. If one of the values falls outside the threshold, the healthcare provider will be notified. The gynaecologist or midwife can then get in touch via the app or telephone to give the pregnant woman the appropriate advice. The app is combined with a care path of a minimum number of hospital visits.
A recent publication in the international trade journal, Pregnancy Hypertension, documented the results of the pilot study of 103 patients. The study showed fewer clinic visits, fewer ultrasounds and fewer admissions related to hypertension in the SAFE@Home group, compared to patients who received regular care. The pregnancy outcomes remained the same.
Both the pregnant women and the professionals were very positive about working with SAFE@Home; pregnant women also indicated that they felt safer with this form of monitoring. Bekker: “Via SAFE@Home, we can monitor the well-being of patients more effectively. This enables us to take appropriate action to prevent unnecessary hospital visits, diagnostics and probably even admissions“.
Follow-up study SAFE@Home II
After an initial pilot study, the SAFE@Home II follow-up study will begin in October, and several hospitals will be able to participate in the program. Bekker: “This will give us a good insight into aspects concerning upscaling and implementation, as well as the effect on medical outcomes. Since the COVID-19 pandemic, we have also witnessed an additional need for “the right care in the right place”, and telemonitoring such as SAFE@Home contributes to this“. The Prevention Early Diagnosis and E-Health Foundation, and Health Holland, a program of the Top Sector Life Science and Health, are making a research and development subsidy available for this purpose. UMC Utrecht is coordinating the study.
Jeroen Bosch Hospital first participant
Dr. Jacques Dirken, gynaecologist at the Jeroen Bosch Hospital, explains the participation of SAFE@Home within the Jeroen Bosch Hospital. “Just like in Utrecht, we already worked with remote CTGs (heart monitors) to keep an eye on the baby in the womb, with SAFE@Home we can also monitor the mother’s blood pressure. These are two important parameters for monitoring a pregnancy, and now we can do both from home. This is a fantastic innovation, which means we can anticipate possible complications more quickly and reduce the need for pregnant women to visit the hospital”.
Gynaecologist Dirken expects approximately 50 patients from the Jeroen Bosch Hospital to participate in the study. With the implementation of this modern care, more control is also given to the patient. “As pregnant women now regularly measure their blood pressure and complete a questionnaire, they learn to assess what the values mean. Because of this insight, I expect them to be more actively involved in their pregnancy and the care that surrounds it”.
Luscii founder and CEO Daan Dohmen has been appointed as a special professor in the Faculty of Management Sciences at the Open University. In his new position, Daan will play a leading role in the development of research into the effects and implementation methods of digital care.
Of course, Daan is best known as an entrepreneur, but he also obtained his doctorate cum laude for a study on e-health implementation and has since remained active within the field. Prof. Dr. Ir. Dohmen is therefore delighted with his appointment, especially as it concerns an urgent issue that he has been working on for decades.
Dohmen: ‘Our healthcare system is under increasing pressure. Rising healthcare costs and an increasing shortage of qualified healthcare providers are ahead of us if we do not make significant changes. Digital care can help make that change, but it requires more than just the use of fun apps and smart technology. What matters is the advent of technology leading to a much more proactive role of citizens and patients in healthcare’.
The need for transition
According to Daan, a transition is needed from a production model, in which everything is focused on providing care systematically, to an ‘on demand model’, in which the patient takes more responsibility. However, there is a need to ensure that medical support is available at the right time for those who need it. This is precisely where digital technology can play a decisive role.
Research and leadership
As a consequence, existing organisational structures have to be broken down. Otherwise, digital care will just be ‘on top’ of what is currently on offer. The much-needed transition therefore requires more knowledge about the effects of digital care, plus new forms of collaboration and an adaptive culture of innovation. This can be shaped by new leadership and funding models, by both entrepreneurs and existing and new healthcare providers.
This special position has been set up by VEROZ, the knowledge centre for promoting innovation and entrepreneurship in healthcare. The foundation unites entrepreneurs in healthcare and has the ambition to contribute to healthcare innovation through research and education. In collaboration with the Open University, this ambition has now been realised by the establishment of this position and the creation of an MBA in Health Management & Entrepreneurship. The new course will begin in November 2020.
AMSTERDAM, The Netherlands, September 29, 2020 – Luscii healthtech, a leading Dutch technology company providing telemonitoring solutions for patients and clinicians, today announced that it has been accepted as a supplier on the latest version of the UK government’s public sector cloud procurement framework, G-cloud 12.
As of today, Luscii healthtech will be available on Lot 2, cloud software. Operated by the Crown Commercial Services (CCS), the framework encourages the adoption of cloud-based IT-services across the public sector.
“We are very pleased to be awarded the G-cloud 12 certification for the first time. To be listed on the UK government’s market place is a great step forward, driving our mission of supporting digital transformation in the NHS”, according to Rob Brougham, Managing Director UK.
Luscii healthtech, founded in the Netherlands by dr. Daan Dohmen, has over 50% of Dutch hospitals working with the Luscii app. Luscii is a digital platform that hospitals can use to monitor patients at home via telemonitoring. The aim is to prevent emergency admissions and reduce unnecessary outpatient visits. Luscii is now active in 6 countries, has secured worldwide partnerships with Apple and Omron, and has already accomplished over a million virtual care moments.
The UK is a strategic market for Luscii to expand their market presence in Europe. Several NHS organisations are already working with Luscii to provide patients care at home, among them Sunderland and Herefordshire & Worcestershire. Read more about Luscii in the UK or watch this video about how Luscii supports COPD patients in Sunderland.