This is a plain English summary of an original research article. The views expressed are those of the author(s) and reviewer(s) at the time of publication.
An NHS-owned app (HealthCall Digital Care Homes) records care home residents’ health information when they become unwell. The information in the app can be accessed by clinicians at a community hub who advise on people’s treatment.
Researchers found that this approach led to:
- fewer emergency hospital admissions
- fewer attendances at emergency departments
- shorter hospital stays.
More information on Health Call can be found on the NHS website.
The issue: can an app reduce residents’ need for hospital care?
More than 441,000 people live in a care home in the UK. Many have poor health and hospital admissions can be hazardous for them due to the risk of infections, confusion and falls.
The HealthCall Digital Care Homes app is used by care home staff to record residents’ blood pressure, temperature and other observations when they become unwell. Along with information on how the resident is feeling, this data is sent electronically to a community hub where clinicians can advise on the best treatment for each resident. Previously, resident health information was usually provided by care home staff over phone calls, which could take a long time.
This study assessed the impact of the app on unplanned hospital care and the associated costs.
What’s new?
The study included 8,702 care home residents from 118 care homes in England (from 2018 to 2021). Most participants (65%) were women, and their average age was 85 years. The researchers linked app data to hospital records. They assessed residents’ use of hospital care before and after their data were recorded in the app. Participants remained in the study until they died or moved away.
Overall, when staff began recording health information in the app, residents’:
- emergency hospital admissions dropped by 25%
- emergency attendances dropped by 11%
- hospital stays became shorter by 11%.
Use of the app reduced costs by £57 per resident for the NHS in 2018; savings increased to £113 per resident in 2021 (calculations were based on 2019 – 2020 costings, extrapolated to 2021). These costs do not include the initial set up (including staff training) or purchase of app technology.
Why is this important?
The study suggests that the HealthCall Digital Care Homes app, or similar monitoring technologies, could safely reduce care home residents’ contact with hospitals. The researchers say that, with the app, health issues were identified earlier and shared decision making between care home and community clinical staff improved. If the cost savings found in this analysis (£57 per resident) were replicated across the UK, the researchers say it could save the NHS £247 million each year (based on 2019 – 2020 figures).
The study was carried out in the North East of England so the findings might be less generalisable to the rest of the UK. Some of the study took place during the pandemic, which is likely to have had an impact on hospital admissions, for instance. The researchers did not have the data to adjust their findings for resident characteristics (such as age and ethnicity) and conditions; this may have impacted the results.
What’s next?
The findings from the study were shared with NHS England to inform their roll out of digital technologies in care homes. Staff will need to be trained before the system can be rolled out in other homes. In the study, the researchers allowed 90 minutes for training staff on how and when to use the app, how to take the observations, what normal values are (though they were not expected to interpret readings) and troubleshooting.
The researchers say further research is needed in larger populations over longer periods to determine the true impact of the tool.
How does this research fit with my current practice?
You may be interested to read
This is a summary of: Garner A, and others. The impact of digital technology in care homes on unplanned secondary care usage and associated costs. Age and Ageing 2024; 53 1 – 7.
An article about the study from Health Data Research UK and Health Call.
A report on emergency hospital admissions from care homes by The Health Foundation.
Funding: The study was supported by the NIHR Yorkshire and Humber Applied Research Collaboration.
Conflicts of Interest: None declared.
Disclaimer: Summaries on NIHR Evidence are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that the views expressed are those of the author(s) and reviewer(s) at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care.
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