The Impact of Digital Technology in Care Homes on Unplanned Secondary Care Usage and Associated Costs

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>A substantial number of emergency department (ED) attendances from care homes could be classed as avoidable. HealthCall is a technology that aims to streamline residents’ care by recording their observations electronically. Observations are fed to remote clinical staff to triage referrals. This study assessed the effectiveness of the HealthCall technology to safely reduce unplanned secondary care usage and associated costs.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The study involved 118 care homes across the North East from 2018-2021. Routinely collected NHS secondary care data from County Durham and Darlington NHS Foundation Trust was linked with data from the HealthCall technology App. Four outcomes were modelled monthly using Generalised Linear Mixed Models: counts of emergency attendances, emergency admissions, emergency readmissions (28-days), and length of stay of emergency admissions. A similar approach was taken for costs. The impact ofHealthCall was tested on each outcome using the models.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>Data from 8,702 residents was used in the analysis. Results show HealthCall reduces the number of emergency attendances by 11%[6%-15%], emergency admissions by 25% 20%-39%], readmissions reduced by 29%[24%-33%] and length of stay by 11%[3%-18%] (with an additional month-by-month decrease of 28%[24%-34%]). The cost analysis found a cost reduction of £57 per resident in 2018, increasing to £113 in 2021.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p>The introduction of a digital technology, such as HealthCall, significantly reduces contacts with and costs resulting from unplanned secondary care usage by care home residents.</jats:p></jats:sec><jats:sec><jats:title>Funding</jats:title><jats:p>This work was funded by Health Data Research UK, CFC0124.</jats:p></jats:sec>