Covid Recovery Case Studies

App-supported care for Long Covid patients, optimising health care access

In late 2020, the Trust had approximately 4000 patients requiring some level of Post-Covid review following the first wave of Covid. This was a significant challenge magnified by the complex challenges of Covid on the NHS. We developed an app to facilitate a novel approach to the rehabilitative journey, with an MVP in use from August 2020. Patients were invited by the Trust to be screened for after-Covid needs, and were then referred to the app. One patient could be reviewed weekly in about 3 minutes via the app’s dashboard with RAG rated outcomes, tabulated PROM history and easy access to a range of patient facing tools.

Outcomes

• Patients were managed 10 times more efficiently.
• A significant increase in capacity; one physiotherapist could manage a caseload of 100 patients in the equivalent time it would take to see around 10 patients face to face, expanding clinical capacity tenfold without the additional costs of face-to-face appointments.
• In the first six months, 99 patients have been registered on the app. Of these >60% use the app regularly, with engagement probably outperforming that of face-to-face clinics.
• Looking at those patients who have been on the app for at least one week, patients undertake a mean average 7.0 actions per week, covering recording weight and completing a patient reported outcome measure (PROM) such as FACIT-F, Covid Recovery, GAD-7, MRC Breathlessness, D-12, tracking exercise and/or fatigue diary.
• On average each patient has read eleven articles with approximately half of patients creating and tracking goals.
• Patients recovering from Covid-19 report multiple and often variable symptoms. The app allows patients a new tier of healthcare access, providing specialist services in a personalised manner. For these patients, as for many with chronic disease, it is crucial that they feel supported in the process and encouraged in their self-management and rehabilitation.
• This app provides a platform to meet that need in an efficient manner, bridging the gap between clinical care and self-management and improving patient outcomes. Recovery is a journey, and via the app patients can be safely monitored and receive care; this enables them to feel seen, heard and believed.
• We are working with WHO to support international delivery.

Read more on the NHS website.

Using an app to support management of post COVID-19 condition

During the pandemic, the Oxfordshire Post COVID service commissioned the use of the Living With Covid Recovery app to support the management of patients diagnosed with Long COVID. It has had large benefits for both clinicians and patients in its multi-function ability to provide excellent resources, enable symptom tracking, monitor energy expenditure and enable patient accountability directly with the service. As of late 2022, there are 510 registered users in the Oxfordshire Post COVID service.

Main benefits

• evidence-based resources
• symptom tracking features
• adjunct to support information and education received via HCP
• encourages accountability

Clinician and patient feedback

‘I will always check a patient’s dashboard before a consultation so I can help to direct the conversation, and assist in understanding when and where there may have been dips in recovery or increases in symptoms. It helps the patient to understand how useful the information is for them and for us.’ – Emma Tucker, Post COVID Rehab Specialist, Oxford Health NHSFT.

‘In our Fatigue Management workshops we encourage the use of energy mapping and/or activity diaries. Being able to encourage the completion of these within the app is so useful for patients and to show an example taken from within the technology’. – Rachael Rogers, ME/CFS Clinical Lead, Oxford Health NHSFT.

‘Being able to use the app to track changes in my symptoms was really positive for me to be able to see how far I had come on days where I would feel really low and negative about my recovery.’ – Anonymous Oxford Health patient.

Read more on the NHS website.

From late 2020, the COPD Camden Service has been trialling the Living With Covid recovery programme.

Benefits

• It’s responsive, continually developing with the help of those using it, including respiratory experts, physiotherapists and neuropsychologists.
• It enables prioritisation of resource. The team can see the patients who are getting better and those who need more help and can support accordingly. Not everyone needs to be treated the same!
• It enables proactive management of the condition. The team can spot people before they ‘crash’ and intervene if required.
• It enables remote management of a larger cohort of patients in a shorter timeframe.
• Develops understanding of the needs of this patient population and how they respond to treatments, giving opportunity to teach wider teams how to look after these patients.

Feedback

‘The app is a really proactive way of managing people and as clinicians we love that. No one goes to the doctor or physio when they are ok. You go when you are sick, anxious, depressed. The app enables us to spot people before they crash, make contact and offer treatment before things get worse. Instead of meeting people when they are in a heap, we can meet them when they are in the middle, vastly improving their recovery process.’ – Heidi Ridsdale, Clinical Lead and Respiratory Physio.

 ‘As clinicians we are not taught how to work remotely, but with this app enabling us to do just that, we can still do a brilliant job of supporting our patients. Patients can take ownership of their condition and can message clinicians when they need support. We don’t need to worry that we are providing ‘average’ treatment as we are empowering patients with the tools to get themselves better. Their recovery is in their hands but we are going to help, coach and support them along the way.’ – Rachel Okin, Physio for COPD Camden Service.