Experience of home monitoring of children with complex CHD during the COVID-19 pandemic: lessons learnt

Objective: The COVID-19 pandemic presented unique challenges to global healthcare. Face-to-face outpatient care was dramatically reduced. This study implemented a remote consultation service via a mobile app (Pexip) to monitor patients with major CHD. 

Design: Study design was quasi-experimental and prospective. 

Setting: Remote consultations were carried out at a tertiary paediatric cardiology centre in Northern Ireland. 

Patients: Children with major CHD aged 0-16years in Northern Ireland. 

Intervention: The intervention was a Pexip-enabled remote consultation.

Outcome measures: Primary outcome measures included the number of attendances to hospital both initiated and avoided via remote consultation. Remote consultations were conducted by doctor and/or cardiac specialist nurse or by specialist nurse alone (52% vs. 48%). 

Results: In the study, 32 patients enrolled; three were non-responders and a further two excluded. There were 201 remote consultations delivered (mean = 7.4). There were 12 admissions to hospital resulting from the remote consultation; the commonest indication was abnormal oxygen saturations (42%). There were 38 hospital attendances avoided, predominantly related to infant feeding and medication advice (both 42%). 

Conclusions: A significant number of unnecessary hospital attendances were avoided (n = 38). Remote consultation technology proved a user-friendly and valuable adjunct to the provision of ongoing specialist patient care in challenging circumstances. There was a reduction in parental anxiety, and both parents and clinicians found this initiative beneficial to patient care. There was prompt identification of unwell children on remote consultations.