News
New publication in BMJ journals – Mobile technology and delegated work in specialist community services: the EnComPaSS Integration project
6 January 2022
CATCH members Dr Steven Ariss and Professor Sue Mawson, along with colleagues from St Luke's Hospice and Liverpool John Moores University, have a new study published in BMJ Supportive and Palliative Care.
This study demonstrated that digital health technology, designed for remote working, can support flexible, scalable models of community health services, involving a more junior workforce. Concurrent improvements in patient experience and reduced use of emergency services were observed.
The current UK healthcare workforce crisis is particularly severe in community services. A key limitation with traditional service-delivery models is the reliance on practitioners with levels of training and experience to enable them to operate independently. This paper describes a real-world evaluation of the implementation of digital health technology designed to provide remote, real-time support and task delegation in community palliative care services. It explores the ability of technology to support sustainable community workforce models and reports on key indicators of quality and efficiency.
The study was a mixed-methods, theory-driven evaluation, incorporating interviews, observations and analysis of routine data. The focus of this paper is the reporting of findings from pre–post implementation comparison and interrupted time series analysis. Data include community hospice service visits, hospital use by hospice patients and patient reported experiences.
The digital health intervention allowed the service to include a more junior workforce requiring fewer joint visits. No negative changes in hospitalisation were observed and patients reported experiences improved. Changes in hospital non-emergency bed days were inconclusive. However, emergency department admissions reduced significantly. The cost per hour for visits reduced from £16.71 to £16.23 and annual savings of £135,153 are estimated for reduced emergency admissions.
The evaluation demonstrates the value of digital innovation to support programmes of service redesign and begin to address the healthcare workforce crisis, while having a positive economic effect and indicating an improvement to patient experiences.