Dr Lucy Mackillop, Chief Medical Officer at Sensyne Health discusses how remote patient monitoring is likely to become part of the wider healthcare system as we see more digital technologies embedded into routine clinical care
Pregnancy for expectant mothers and their partners can be an especially daunting time, and the pandemic has been associated with an increased risk of anxiety and depression in this vulnerable group. With the UK Government’s guidelines advising pregnant women to practise stringent social distancing and limit face-to-face contact during the COVID-19 outbreak, there has been a concern that women are avoiding clinics and not seeking the in-person health check-ups they need during pregnancy. This can be especially concerning for women with pre-existing health conditions such as diabetes, hypertension. This affects many thousands of women in the UK each year. In fact, it was estimated that last year 20% of pregnant women in the UK were affected by gestational diabetes, and up to 15% of pregnancies were affected by hypertension.
Gestational diabetes is a condition which, if not treated, can cause serious complications for the mother and baby both during pregnancy and after birth. The risks however can be greatly reduced, if the condition is detected early and is well managed. Left undetected or untreated, it can cause problems including for the baby, pre-term birth, birth trauma and an increased risk of stillbirth; and for the mother, pre-eclampsia and an increased risk of caesarean section.
Medical problems in pregnancy such as those mentioned above are becoming more prevalent world-wide, caused by a combination of factors including more women having pregnancies at an older age and health risks associated with the obesity epidemic. It is, therefore, vital that we learn from the rapid uptake of technology for remote monitoring during the Covid-19 pandemic to ensure treatment is provided to those who need it the most, wherever they may be. So that we can best use it to support women and healthcare professionals now and in the future.
Providing reassurance and support with Remote Patient Monitoring (RPM)
Pregnant women are considered to be one of the vulnerable groups and recent research suggests they may have an increased risk of severe COVID-19 infections. As a precaution, published national guidelines advocate a reduction in hospital visits where possible during the pandemic. Less face-to-face appointments presents a significant opportunity for remote patient monitoring to help protect women from infection while allowing some important aspects of care to be delivered from the comfort and safety of women’s own homes. This form of remote monitoring can have positive impacts on a woman’s sense of security and wellbeing during pregnancy – particularly in a time of great uncertainty.
Digital technology and more specifically, the adoption of remote monitoring via smartphone apps has increased dramatically during the time of COVID-19. In the third week of April 2020 alone, more than 75% of all NHS practices reported that they used some form of digital technology i.e. video consultation, to see patients, compared to just 10% before the pandemic. Remote patient monitoring is becoming the new norm and in the case of pregnant women, it’s becoming key to ensure frequent monitoring of some aspects of care can be safely delivered.
GDm-Health and BPm-Health are both examples of prescribed digital therapeutics for the remote monitoring of diabetes and self-monitoring of blood pressure, respectively. They empower women to manage their health, while receiving support from their healthcare teams who are able to monitor these conditions remotely in near real-time and intervene if necessary. This could include checking a women’s glycaemic control by reviewing her blood glucose readings, and prioritising care to women most in need whilst still providing efficient and effective care to all patients.
The rich source of data from RPM applications provides opportunities for analyse to gain better understanding of health and illness. This, in turn, can lead to the development of data driven decision support tools which may, for example, help clinicians make earlier diagnostic or treatment decisions whether that’s advising dietary changes, recommending exercise for pregnant women to help manage blood glucose levels or intervening earlier when medication is needed. Using patient data effectively may also help to alleviate the pressure on our health services, by allowing resources to be focussed on where they are needed most.
Making RPM part of healthcare beyond lockdown
Lockdown’s strict measures might be starting to ease and as we resume life as close to normal as possible it is clear that staying safe and taking control of our health is a priority and will continue to be – especially for the vulnerable groups in our society such as pregnant women. The pandemic has tested the flexibility of our healthcare systems and has highlighted the value of RPM. It has empowered us to proactively manage our health and aims to help the NHS, an already resource-limited service, manage large numbers of patients under the most challenging conditions.
RPM is very likely to become part of the wider healthcare system as we see more digital technologies embedded into routine clinical care, helping us adapt to the new post-pandemic world we find ourselves in.
Dr. Lucy Mackillop is a consultant obstetric physician at Oxford University Hospitals NHS Foundation Trust; Honorary Senior Clinical Lecturer, Nuffield Department of Women’s and Reproductive Health, University of Oxford; and Chief Medical Officer at Sensyne Health.