Respiratory Remote Monitoring

We will provide you with some simple equipment which records your heart rate, breathing rate, temperature and blood oxygen level and transmits the readings to the clinical team at the hospital so they can monitor your progress. We may also provide you with a blood pressure cuff and spirometer (a device which provides more detail about how well your lungs are working) and ask you to use these to take some additional readings. We will ask you to record any symptoms you have using a tablet device which we will provide.

If the clinical team is concerned about any of your readings, or the readings suggest that you are not improving, they will get in touch with you. You can also send a message to the clinical team on the tablet device if you are feeling more unwell.

We will also give you a pulse oximeter to use at home in the evenings and at weekends when the virtual ward is not staffed. This will allow you to see and record your own heart rate and blood oxygen level. The virtual ward information leaflet provides guidance about actions to take if you are feeling unwell or the readings from your pulse oximeter are concerning.

Is it safe?

Monitoring people outside hospital, using remote monitoring technology, is known to be a safe way of delivering care. It is widely used in different parts of the UK to monitor patients to avoid them having to be admitted to hospital, or to enable them to be discharged from hospital earlier.

We will provide you with a kit containing different items. (add images)

• Wearable device - Monitors your readings, such as heart rate and blood oxygen level.

• Strap size guide - Used to measure the strap size for your wearable 

• Straps - Holds the wearable on your arm

• Home hub - Connects your wearable to the internet

• Charging dock - Charges your wearable and tablet

• Tablet - Displays tasks assigned to you by your care team

• Tablet stand - Holds your tablet

• Ethernet cable - Connects your Home Hub to your internet router (if required)

You may also be given the following devices.

• Blood pressure cuff - Measures your blood pressure

• Spirometer - Measures your lung function

We will show you the kit before you leave hospital and will go through the information leaflets showing you how to set up and use all the equipment. You can also follow the set up instructions when you switch on the tablet at home. Most people find it straight forward to get everything set up but help is on hand if you are worried about doing this.

If you have any problems setting up your equipment, or getting things to work, type help.currenthealth.com into your browser. This site has some useful videos to show you how to set up your equipment. Alternatively, you can call the Current Health support desk number 01472 732 037 any time of day or night, free of charge, and someone will help you. You will need to give the name of your hospital (Borders General Hospital) and the name of the kit, which can be found on the box the device came in and on the device itself.

What do I do with the wearable?

You will need to put the wearable device on your arm, above the elbow and leave it there most of the time, except when showering or bathing. Straps are provided to hold it in place.

You should avoid the following areas: areas of your arm which have a lot of hair, moles or areas of raised skin, deep wrinkles, areas of pitted skin, or scar tissue,  tattoos or areas of varying skin tone, sunburn or inflamed skin,

You must charge your wearable for at least 30 minutes every day.

You can charge it while wearing it on your arm or you can remove it for a short time and charge in the charging dock. Please see the instruction leaflet you have been given for further information.

What is the Home Hub?

The Home Hub is a device that connects to the cellular network in your area so the data from your wearable and devices can be transmitted. Your home hub should show three solid blue lights within five minutes of plugging into an electrical socket. If this does not happen, you can connect the Home Hub to your internet router using the ethernet cable.

Do I need to have my own internet connection?

No. The home hub will automatically connect to the best cellular network in your area. It usually works well in most areas, including more remote and rural areas. If you have any problems then follow the instructions in the leaflets provided or call Current Health’s support desk number.

Do I need to stay at home when I am being monitored?

You can walk around and undertake normal activities with the wearable device on. If you leave your home the wearable will continue to record data for up to 10 hours as long as your device is charged. This information will be- transmitted when you are back at home and in range of your Home Hub.

What do I do with my tablet?

You can see all the tasks your clinical team has asked you to complete on your tablet, such as measuring your blood pressure at different times of the day or completing a symptom questionnaire. If you forget to do these tasks you will receive a reminder on your tablet.

The clinical team will arrange video calls on your tablet so they can speak to you and see how you are doing. You can also send a message from your tablet to let your clinical team know you are feeling unwell.

You will need to keep your tablet charged to ensure the clinical team can contact you. Please note that this tablet is not set up for you to use for any other purposes.

How will the clinical team see my data?

The data from your wearable device is transmitted continuously and can be viewed by the clinical team on an electronic dashboard. They will be able to see any data recorded from other devices, such as the blood pressure cuff or spirometer. They will also be able to see any symptom questionnaires you have completed on your tablet device.

How do I know that my data is being transmitted?

Three solid blue lights on your Home Hub indicate that this is working normally. Red and green lights should be visible on the wearable when it is in contact with the skin on your arm. Your clinical team can see if your data has not been transmitted when they review the dashboard and will contact you to check if you have been
having problems and to make sure your devices are charged.

What happens if my Home Hub or some of my devices are not working properly?

If you are having problems with any of the devices then please read the instruction leaflets provided, which have troubleshooting tips and frequently asked questions. There are also some useful tips on Current Health’s website https://currenthealth.com/. Go to the section called “For Patients” at the top of the web page.

Alternatively, you can call the Current Health support desk number 01472 732 037 any time of day or night, free of charge, and someone will help you. You will need to give the name of your hospital (Borders General Hospital) and the name of the kit, which can be found on the box the device came in and on the device itself.

What happens if my readings are abnormal?

Your clinical team will decide what readings are acceptable for you and these will be set up on the system. If your readings are outside this range the system will create an alert. The clinical team can view alerts on a dashboard, which will be monitored regularly during weekdays, and will contact you directly if they are concerned about any of your readings.

When will I be contacted after I go home?

One of the clinical team at the hospital will get in touch with you within 24 hours to find out how you are getting on and to answer any questions you have. We will usually arrange a video call with you. You will be contacted every day initially, to discuss your readings and symptoms. You will usually be contacted in the morning. Once you are stable, or improving, we may contact you less often.

If we are worried about your reading we will contact you between 9am and 5pm Monday to Friday, which are the hours the team will be monitoring your data.

Who will contact me?

While you are being monitored on the virtual ward you will be under the care of one of the Respiratory consultants at the Borders General Hospital. You may be contacted by a doctor, senior nurse or senior physiotherapist, who will review the data from your devices and find out how you have been. Your progress will be discussed with a consultant each day on a daily ward round. If your readings have been abnormal, or you have had more symptoms than usual, he/she may decide to arrange a follow up call with you later in the day to determine whether it is safe for you to remain at home or whether you need come to the hospital for a face-to-face assessment.

What happens if you can’t contact me?

We will usually schedule a video call with you and will send you a notification on your tablet to remind you. It is important that we also have a phone number for you so we can try and contact you by telephone if you do not answer the video call.

How long will I be monitored for?

We will usually monitor you for a few days. The length of time will vary depending on your clinical condition. In most cases this will be for less than a week but occasionally we may monitor you for up to two weeks.

Will someone be monitoring me the entire time I am at home? 

As we have a small Respiratory team we are only able to staff the virtual ward between 9am and 5pm Monday to Friday.

What happens after 5pm?

You will not be able to see the readings that are transmitted to hospital from your Current Health wearable device so we have also given you a pulse oximeter. Someone at the hospital will show you how to use this. This helps you monitor how fast your heart is beating and the level of oxygen in your blood.

We would like you to check your heart rate and blood oxygen levels around the time you have your evening meal and just before you go to bed each night. We will provide you with a paper diary to record the results and any symptoms you have. If you are worried about these readings follow the guidance you have been given in the Virtual Ward Patient Information Leaflet.

When you are contacted by one of the Respiratory team during the week you should let them know the readings you have recorded using your pulse oximeter. The Respiratory team will also be able to see any data that was recorded from your wearable device and any readings from your blood pressure monitor or spirometer, if you used these.

What happens at weekends?

We would like you to record your heart rate and blood oxygen level four times a day on Saturday and Sunday using the pulse oximeter. This should be shortly after you get up, around lunchtime, around the time you have your evening meal and before you go to bed. You should record these readings in your diary, along with any symptoms you have. If you are worried about these readings follow the guidance you have been given in the Virtual Ward Patient Information Leaflet.

On Monday morning you should let the Respiratory team know your readings from Friday evening to Sunday night when they contact you. Your clinician will also be able to see any data recorded from your Current Health devices over the weekend.

What blood oxygen level and heart rate are normal?

An ideal blood oxygen level is between 95% and 99% but if you have an underlying Respiratory condition your usual blood oxygen level may be much lower than this. We will tell you what levels are acceptable for you. An ideal heart rate is between 50 and 90 beats per minute.

Should I use my Current Health devices overnight and at weekends?

Yes. You should continue to use your wearable device, check your blood pressure (if asked to) and complete your symptom questionnaires on your tablet device in the evening and at weekends. The clinical team will be able to see the data recorded from these devices when they next look at the clinical dashboard.

As you will not be able to see any of the information that is transmitted to us from the Current Health devices we need you to use the pulse oximeter to monitor your readings and to follow the guidance you have been given if you are feeling unwell or you are worried about your readings.

What should I do if I am feeling unwell?

If you are feeling unwell during the hours of 9am to 5pm Monday to Friday you can press the button on your tablet to let us know. Someone will be monitoring the dashboard intermittently during the day and will respond to any alerts. You can also call 01896 826647 or 01896 826640 if you are concerned and one of the clinical team will get back to you as soon as possible.

At all other times please follow the guidance you have been given in the Virtual Ward Patient Information Leaflet.

If you need to come into hospital for any reason you should leave your monitoring devices and pulse oximeter at home. If you have become unwell and need to be seen in the Emergency Department, or admitted to a ward, you should let the doctor or nurse who sees you know that you have been remotely monitored at home.

You should tell them the readings you have recorded using your pulse oximeter. One of the doctors in the hospital will also be able to look up the readings which were recorded on your Current Health devices.

When I am discharged or choose to discontinue the monitoring

What if I decide I don’t want to be monitored any longer?

If at any time you decide you do not want to continue to be monitored by the hospital team let the doctor or nurse know when they contact you. Alternatively you can call 01896 826647 or 01896 826640. This will not affect any future care.

When you are discharged from the virtual ward we will send a discharge letter to your GP. This will let him or her know you are no longer being monitored by the hospital team. You will also receive a copy of this letter.

Feedback questionnaire

When you are ready to be discharged we will also ask you to complete a feedback questionnaire which will be used to help us evaluate the service and how easy or difficult you found the remote monitoring technology to set up and use. You will be able to do this on your tablet device.

Usually when you complete a questionnaire or send information from your tablet device it can be seen through the clinical dashboard. However, the information from the feedback survey cannot be seen by anyone at the hospital. We will receive an anonymised report that summarises all the feedback received from patients without us being able to see who completed the surveys. This means you can be completely honest about your experience.

What do I do with the equipment after I am discharged?

Once you have been discharged from the service, we need you to pack up all your Current Health equipment in the boxes and bags provided. It is important that all this equipment is returned to us so that we can clean it and use it again for another patient. Once you have packaged everything up you can either bring all the kit
back to the Respiratory Secretaries office. Follow the signs for wards 4, 5 and 6. The office is located on the left hand side of the corridor before you reach the wards. Alternatively we can arrange for the kit to be collected from your home.

You can ask the clinician who contacts any questions you have. If you wish for someone to contact you at other times please call 01896 826647 or 01896 826640 Monday to Friday between 9am and 5pm and leave a message. One of the clinical team will call you back as soon as they are able to during the day. Please do not contact your GP if you have any questions about this remote monitoring project as they will not be able to help.

What happens to the information collected about me?

All the information recorded from the Current Health devices, any symptom questionnaires you have completed, and all notes made by the clinical team after they have contacted you are held in Current Health’s platform. 

When you are discharged from the virtual ward a summary report of all this information will be created and will be added to your hospital electronic health record. This means that any clinical staff in the Borders General Hospital who need to look after you in the future are aware that you were monitored on the virtual ward and can see what your readings were.

In addition, the information will also be used to help NHS Borders evaluate the virtual ward to see whether this service helped people stay safe at home and identify any improvements that could be made. It will also help us to find out what patients thought about the technology. Any information used for this purpose will be anonymised. That means it will not include anything that could identify you.

Does this mean people working for Current Health can see my clinical information?

No. Staff working for Current Health cannot see the readings from your devices, any symptom questionnaires you complete on your tablet device or any clinical notes recorded by your care team.

NHS Borders has completed a full assessment to make sure Current Health’s platform and devices meet all required security standards and that data is held safely and can only be accessed by people with a legitimate right.

You can read more about how your information is used and kept safe by NHS Borders here:
http://www.nhsborders.scot.nhs.uk/corporateinformation/privacy-notice/

This also includes contact details in case you have questions or concerns.