Virtual ward platform technologies for acute respiratory infections

2.1 A virtual ward platform technology comprises a patient-facing app or website, medical devices for measuring vital signs and a digital platform for healthcare professionals. The aim of these technologies is to expand the capacity of the acute care sector by monitoring people, who would otherwise be in hospital, remotely in their home or usual place of residence. Several virtual ward platform technologies are available in the NHS. NICE identified 20 companies as part of the scoping process. Of these, the following 13 companies provided information on their technology:

2.2 Technologies can be used once they have appropriate regulatory approval, including CE mark, and meet the standards within NHS England's Digital Technology Assessment Criteria (DTAC). Any associated medical devices needed to measure clinical parameters must also have appropriate regulatory approval and meet local testing standards. The Medicines and Healthcare products Regulatory Agency (MHRA) advise that the virtual ward platform technologies evaluated will likely be classified as class IIa or higher under the UK Medical Device Regulations 2002 (UK MDR 2002, as amended) based on the scope of the project. For software platforms that continuously or automatically monitor vital signs and provide specific warnings of a person's condition, particularly when there may be quick deterioration, are likely to be class IIb. When a virtual ward platform technology is connected to associated medical devices, the software should be classified at the highest classification of the associated medical device(s). Classification of device will be product specific and based on the intended medical purpose that is stated by the manufacturer in their device's labelling, instructions for use and promotional materials and its mode of action in conjunction with the definition of a medical device as stated in the UK MDR 2002. Information on the classification of medical devices, including virtual ward software platform technologies, can be found on the MHRA's public access registration database.

2.3 NHS England's guidance on acute respiratory infection (ARI) virtual wards provides a framework for the setup of virtual wards for people with an ARI, including information on staffing and out-of-hours care. People can be admitted to a virtual ward either from a hospital setting as an early discharge, as an alternative to hospital admission, or via direct patient–NHS contact. A clinical assessment of suitability for admission to a virtual ward should be carried out in person by a healthcare professional. It should include a review of symptoms, function, clinical observations, appropriate diagnostics, clinical severity scoring, overall clinical trajectory and a shared decision-making discussion about any support the person or their carers may need. Suitability of the person's usual place of residence should also be considered, such as whether there is access to a fixed or mobile telephone line, running water, heating, electricity and access to meals. The person or their carers would also need the confidence, motivation and skills to be able to use a virtual ward platform and the associated medical devices. On admission to a virtual ward, plans relating to monitoring, escalation of care and discharge should be made.

2.4 Virtual ward platform technologies would be used as an alternative to inpatient secondary care, care in the community or care in the person's usual place of residence without the use of a virtual ward platform technology.