Exploring remote observation-augmented clinical assessment in out-of-hospital emergency care: implications for ambulance services
Ela Lewis, James Gough, Mike BradyBackground
UK ambulance services face sustained pressure from rising demand, workforce shortages and limited community capacity. While virtual wards have adopted remote monitoring technologies, their use within emergency ambulance triage remains limited. This early-stage innovation report describes the introduction of Remote Observation Augmented Clinical Assessment (ROACA), a short-term clinician-directed model for obtaining and interpreting remote physiological observations to support telephone and video triage and consultation.
Methods
A descriptive observational evaluation was undertaken from August 2024 to January 2025 across residential and nursing homes in Wales and with a small number of community responders. Clinicians used the Luscii digital platform to request and review observations, augmenting existing triage and consultation workflows. Inclusion and exclusion guidance focused on cases where short-term remote observation could support safer, more informed decisions during delays or when community pathways were unavailable.
Results
A total of 143 cases were onboarded to ROACA. In 36% of cases, ambulance attendance was not required, with patients managed via existing community pathways such as general practice or district nursing. For cases requiring on-scene assessment, ROACA informed the response type and urgency and supported the identification of both deteriorating and stabilising patients. Clinicians and care home staff reported improved connectivity and reassurance although clinicians noted an increase in time per case. Data limitations prevented assessment of longer-term outcomes or comparative effectiveness.
Conclusions
ROACA shows early promise as a feasible augmentation to remote clinical assessment, supporting clearer decisions and care closer to home. Further structured evaluation, wider deployment and improved interoperability are needed to assess long-term impact.