Virtual care with remote monitoring reduces patients’ pain, drug errors: study

Patients monitored virtually after nonelective surgery had significantly reduced pain and greater detection and correction of medication errors, according to researchers at McMaster University in Ontario.

The national study, published this week in the British Medical Journal (BMJ), analyzed outcomes of post-surgical patients that received care virtually and through remote automated monitoring (RAM). Care included video calls with doctors and nurses, and use of wearable devices for self-monitoring of vital signs.

The study also looked at the impact that virtual care and automated monitoring had on easing hospital burden.

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“We began the study in the first months of the pandemic, when hospitals were challenged to drastically reduce non-emergency care,” P.J. Devereaux, a senior scientist at the Population Health Research Institute (PHRI) and a professor and director of the division of perioperative care at McMaster University, said in a university news release.

“Our study provides proof of concept that virtual care with RAM can improve outcomes after discharge following nonelective surgery – outcomes that are important to patients,” Devereaux, who is also the co-principal investigator of the study and cardiologist and perioperative care physician at Hamilton Health Sciences, said in the release.

The researchers explained that half of 905 post-surgery patients at eight sites in Canada were randomly selected to use a cellular tablet and RAM equipment at home to collect data that was sent back to the health care team. Patients’ vitals were measured for a 30-day period after leaving the hospital, and patients also took photos of surgical wounds, with access to a physician or nurse at all hours, seven days a week.

The other group received standard care, which included seeing their health care provider in person within 30 days of hospital discharge, and patients were instructed to inform their surgeon about any medication or symptom concerns. Study authors found that more medication errors were detected in patients in the virtual care group compared to the standard care group (30% versus 6%, respectively) and corrected (28% versus 4%, respectively).

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What’s more, fewer patients in the virtually monitored group had to return to the hospital for care (22% versus 27%, respectively) and fewer patients receiving virtual care reported pain at time intervals throughout the month, with an up to 14% reduction versus the standard care group.

“Frontline nurses have the opportunity to lead the charge in terms of virtual care from hospital to home, in collaboration with physicians and allied health colleagues,” Devereaux said in the release.

The authors also suggested in their analyses that when a patient received a high standard of virtual care and RAM with frequent involvement with their health care provider, fewer urgent care center or emergency department visits occurred. However, lower standards of virtual care weren’t associated with such improvements.

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 “The pandemic is just the tip of the iceberg, in terms of virtual care’s potential, and how healthcare can be transformed,” Michael McGillion, a PHRI scientist and an associate professor of McMaster’s School of Nursing and co-principal investigator of the study, added in the release.

The authors recommend further trials to improve efficiency and cost effectiveness of virtual care with RAM. 


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