Remote-by-Default Care in the COVID-19 Pandemic

University of Oxford

Status: Completed

Conditions: COVID-19

Study type: Observational

Funder types: Other

Identifiers

NCT04435041

283196

Details and patient eligibility

About

18 month study, funded by ESRC COVID-19 research fund. The aim is to explore and support the rapid shift from face-to-face to remote (telephone and video) conversations in primary care. There are three components: a study of clinical interactions and decision making (micro); four locality-based organisational case studies of new models of care (meso); abd a a study of how digital innovation can support NHS infrastructure and vice versa (macro).

Full description

18 month study, funded by ESRC COVID-19 research fund. The aim is to explore and support the rapid shift from face-to-face to remote (telephone and video) conversations in primary care. There are three components: a study of clinical interactions and decision making (micro); four locality-based organisational case studies of new models of care (meso); abd a a study of how digital innovation can support NHS infrastructure and vice versa (macro). The methods are mainly qualitative (interviews, virtual ethnography, analysis of documents, micro-analysis of conversations) and are designed to inform action research.

Key deliverables:

At least two evidence-based assessment tools: qualitative (questions for remote assessment of breathlessness) and quantitative (a COVID-19-specific early warning score)

Transferable lessons about how to achieve rapid spread and scale-up, spread in real time through our extensive intersectoral networks

Strengthened infrastructure for supporting digital innovation in the NHS

Enrollment: 103 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Inclusion criteria for interviews

Willing and able to give informed consent for participation

Aged 18 years or above

Staff involved in delivering remote-by-default services in the frontline or 'back offices'

Patients/carers who have crossed paths with primary care services during the Covid pandemic.

Pharmacy case studies:

Staff involved in delivering remote pharmacist consultation services in the frontline or 'back offices'

Patients/carers who have crossed paths with community pharmacy primary care services during the COVID-19 pandemic.

Inclusion criteria for video and telephone consultations

Patients who have remote primary care consultation regarding symptoms associated with COVID-19 and their clinicians (based in Oxford/Thames Valley) who have agreed to participate in the study

Inclusion criteria for focus groups

Patients that have experienced self-reported 'long Covid' symptoms (for patient only focus groups)

Clinicians that have experienced self-reported 'long Covid' symptoms (for clinician only focus groups)

Exclusion criteria

Patients or clinicians who are too ill to be interviewed

Trial design

103 participants in 4 patient groups

Remote assessment tools

Description:

Qualitative methods: semi-structured interviews for approx 40 front line clinical practitioners

RECAP early warning score

Description:

Development of disease specific early warning score, building on earlier work through literature review and NEWS2 score

Implementation/Scale up case studies

Description:

Study of implementation and scale up of remote-by-default at four different UK sites

Infrastructure strengthening

Description:

Theory and data driven change effort involving policymakers, regulators, professional bodies, industry, patients and citizens with a view to overcoming interacting issues impacting success of digital projects.