Digital technology could reduce A&E attendance

The use of digital technology in residential care homes can reduce the number of emergency department attendances by 10% each month, according to new research.

Preliminary evidence from a study that modelled the effect of implementing the UK’s National Health Service (NHS) HealthCall digital technology across the North-East of England showed it had the potential to make a significant impact on attendances by residents of care homes in accident and emergency (A&E) departments.

The author of the research, Alex Garner, a Lancaster Medical School PhD student, said, “Care homes that are registered with HealthCall are provided with devices on which the staff can use the app. Staff are trained on taking observations of residents’ condition, such as body temperature and blood pressure, and uploading these observations to the app. They can also include text about a person’s condition. The observations are sent to a clinician at a central hub who has access to the resident’s NHS healthcare record. The clinician can then provide advice for staff on next steps in the resident’s care. The advice might be to keep monitoring the resident, or for a healthcare professional to visit, or to take them to an emergency department.”

Garner and his colleagues collated data on 8702 care home residents in 122 homes from County Durham and Darlington NHS Foundation Trust and linked these with clinical data from HealthCall. Using this information, they created statistical models to predict how rates of A&E attendances changed over time. The models took account of fluctuations caused by the time of year and also the COVID-19 pandemic.

“Our preliminary models suggest a 10% reduction in the expected monthly emergency department attendances for residents in care homes using the technology compared to attendance rates before it was introduced.

“There is insufficient evidence so far to suggest that the use of HealthCall could result in an additional gradual decrease in emergency attendances for individual residents over time, but we are investigating this further.

The researchers continue to develop their modelling and investigate the impact of HealthCall technology length of inpatient stays, number of community nurse visits, rates of A&E admissions compared to transfer back to the care homes, rates of A&E arrivals by ambulance and whether any of these outcomes are affected by how much the care homes use the app.

The technology is now being rolled out to a further 300 care homes in the north of England.

“Our study shows that digital technology could bridge the gap between health care and social care in the UK, provide staff with ready access to clinical expertise and potentially improve the quality of life for care home residents,” Garner said.

Previous research has suggested that some emergency hospital admissions of care home residents in the UK may have been unnecessary, as well as being detrimental to residents’ wellbeing.

“Care homes look after some of the most vulnerable members of our society. Ensuring residents receive the correct level of care is of utmost importance. It is hoped that having quick access to this type of advice can lead to reductions in A&E attendances and hospital attendances through providing more targeted care in the home,” he said.

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