Healthcare company Huma is helping the UK’s National Health Service (NHS) create virtual wards to monitor and care for patients who are at home in isolation with moderate symptoms of Covid-19.

The project aims to see how healthcare teams can get patients to hospitals at the right times for better outcomes, better support early intervention to avoid patients needing ITU care and help prevent virus spread.

London-based Huma is working with the NHS’s digital transformation unit NHSX to provide remote monitoring for Covid-19 patients who are at-home, in quarantine or self-isolating. Developed with international clinicians and academics, Huma has worked with NHSX and local NHS organisations to configure and trial its Medopad Covid-19 remote patient monitor (RPM) in six sites to support the response to the pandemic.

A number of NHS sites are now working with Huma’s technology to support virtual wards to monitor and care for patients. Medopad enables the accurate exchange of health data and information between patients and their NHS care team. Healthcare teams can closely monitor a patient’s symptoms to advise on appropriate care and early intervention, staying informed of symptoms and being alerted to disease progression that could avoid further complications or prompt a diagnostic procedure, a visit from a clinician or a visit to hospital if needed.

“This is a great example of how new technology is supporting healthcare professionals to provide the right care at the right time,” said Tara Donnelly, chief digital officer at NHSX. “With Covid-19, it’s vital that we make use of digital tools that can help support patients who don’t need immediate hospital care and allow close monitoring of their condition. The feedback we are getting from patients is that the remote monitoring with clinical oversight is really reassuring to them, and they are grateful to be at home while they recover, rather than in a hospital bed. The clinical team is finding it helps give them very rapid feedback on their patients and they are able to keep an eye on a number of people at a glance, which is working much better for them than the previous system which relied on phone calls.”

The Covid-19 remote monitoring trial phase started in London and Hertfordshire in both primary and secondary care settings to support patients with symptoms.

The initial projects were:

• Watford General Hospital, part of West Hertfordshire Hospitals NHS Trust, is using the Covid-19 RPM for patients with mild-to-moderate symptoms via a virtual ward to support patients who have been discharged from hospital and also to avoid admissions for those whose care can be safely managed in their own homes.
• North West London trial is in two primary care led hot-hubs in Hillingdon and Soho. These hot-hubs provide at-scale triage from general practice and 111 for patients who are deemed to require on-going monitoring of symptoms and has been extended to services in Harrow and Ealing.

“Our teams are working to provide the best care for patients with Covid-19 symptoms around the clock,” said Matthew Knight, respiratory consultant at Watford General Hospital. “To provide the best patient care and outcomes, protect the NHS and prevent community spread, the remote patient monitoring offers a promising solution to help us scale our efforts to the growing needs of our community.”

Tony Willis, clinical director for diabetes at North West London Collaboration of CCGs, added: “Patients with suspected Covid-19 can deteriorate in a matter of hours. That’s why it’s vital that clinicians can track their symptoms and vital signs regularly so that they can intervene if there is significant deterioration. But patients do not have to be at the hospital or clinic all the time and this new solution means we can capture patient health data frequently enough to take timely action while the patient is in the comfort of their own home.”

Within weeks, teams from the three initial sites, NHSX and Huma went from concept and ideation to implementation, collaboratively developing several iterations of the app to meet local requirements and work across systems. Huma’s team needed only eight days to create the technical requirements to get up and running, configuring modules such as patient questionnaires, symptom tracking and user flows with clinicians at the trial sites to customise clinical pathways. Healthcare practitioners at the local sites were trained on using Medopad in mid-April and the project has since been rolling out to patients.

“As a British company, we can think of no greater honour than being part of this pilot that is helping three NHS trial sites respond to the Covid-19 pandemic in this hour of need,” said Dan Vahdat, founder and CEO of Huma. “We are proud to use the learnings we’ve developed with our NHS partners to provide care for many Covid-19 patients to help people support the NHS and save lives.”

Huma is providing its Medopad Covid-19 RPM as a not-for-profit initiative.

“NHS staff are working tirelessly to provide care during this crisis,” said Aida Yousefi, chief commercial officer of Huma. “It is an honour to have the opportunity to trial our technology to lessen their burden at these sites by providing the reassurance that their patients are being monitored accurately and appropriately. Equally, isolated and worried patients in the community can have the reassurance that they are being looked after remotely and appropriately by their healthcare teams. It has been a privilege to work with NHSX. Together we have worked at speed to implement in less than three weeks.”

Medical staff monitor patient care via the Medopad web-based clinician portal. Healthcare teams can prioritise patients based on patient-submitted data and auto flagging, access telemedicine capabilities allowing the care team to video call the patients, and view team notes and detailed patient profiles.

Patients receive easy-to-follow instructions on how to access the service via email or text with a unique code to download and access the Medopad mobile app. With patient consent, patients use self-assessment and testing tools via the mobile patient app, including body temperature, heartbeat frequency and breathing difficulties. Patients may also receive an oximeter device to measure SpO₂ level for oxygen saturation and heart rate without needing to connect any hardware to their mobile device.

Medopad Healthcare Practitioner telemedicine portal features include:

• Alerts and thresholds: Set alerts and thresholds to ensure Covid-19 patients are seen at the right time by the right clinician
• Secure: Secure portal for ease of viewing on desktop or mobile
• Telemedicine: Telemedicine available to engage with patients easily
• Data visualisation: Patient-level data analysis and visualisation
• Rules-based triage: Opportunity for rules-based triage to promote efficiency
• Manage multiple patients with ease: Ability to manage multiple patients at once and divert care to the ones most in need
• Instant reach out to patients: Reach out to patients directly and adjust their care plan thresholds if necessary
• Rich data: Rich data to enable a comprehensive review of Covid-19 patients to understand disease progression, evolution of symptoms and adverse reactions nationally
• Optimise time and resources: Reduce face-to-face visits for faster responses and to reduce the spread of the disease

Medopad is configured to monitor and flag deterioration in Covid-19 patients. It supports self-management through a simple analytics dashboard. It requires an iOS or Android smartphone, and can be combined with other devices such as an oximeter. Patients submit symptom ratings once per day. Each symptom is rated by the patient as mild, moderate, severe or very severe. The app is prescribed by clinicians to Covid-19 positive patients.

The Medopad patient app modules for the trial include:

• Symptoms: including fever, cough, shortness of breath, muscle aches, nausea, vomiting, diarrhoea, headache, unusual chest pain or tightness, dizziness, loss of consciousness, and heart palpitations
• Breathlessness: using a simple respiratory questionnaire
• Temperature: measured via temperature dot or thermometer
• Resting heart rate: captured via patients’ smartphone camera through photoplethysmography (PPG) or pulse oximeter device
• Oxygen saturation: captured via pulse oximeter device
• Information: Covid-19 specific learning and education content provided by NHS
• Telemedicine: Ability for clinicians to speak with patients when necessary

Huma is based in London and has offices in Shanghai, California and New York. It produces applications that integrate health data from existing hospital databases as well as patient wearables and other mobile devices and securely transmits them for use by doctors.