“Honestly it’s hard to put into words what it’s done for me, it’s just changed my life,” according to Liam, a Donegal COPD (Chronic Obstructive Pulmonary Disease), commenting on an initiative that empowers patients to manage their conditions at home. Reflecting on his experience before joining the initiative, Liam said he had “lost count of the number of admissions” to the hospital. He added that he found it “very comforting that you had your IPAD and that there was somebody, somewhere looking at it.”
Clinical Lead for the Community and Acute Respiratory Excellence (CARE) Virtual Ward, Donegal, Dr Bukari, commenting on a recently published evaluation of the project noted that “the CARE Virtual Ward has helped patients stay well, avoid hospital admissions, and feel safer and more supported, all while easing pressure on our hospitals. This evaluation shows that Integrated, digitally enabled care is both practical and effective. It is a model that could transform how we manage chronic conditions in Ireland.”
The Donegal initiative is acknowledged to be significantly changing how COPD is managed, delivering significant clinical and economic benefits.
Using Bluetooth-enabled monitoring devices to track respiratory rate, oxygen saturation, and heart rate, patients are safely cared for at home while their data is reviewed daily via a traffic-light triage system. This enables early intervention when signs of deterioration appear and provides a step-down option after hospital discharge, reducing readmissions.
Patients also receive multimedia education, personalised care plans, and rescue medication packs, with referrals accepted from GPs, Respiratory Advanced Nurse Practitioners (ANPs) and the COPD Outreach Team.
It has been developed as a 20-bedded remote care model funded by the Sláintecare Integration Fund. Launched almost two years ago, it has now been independently evaluated, with results showing major reductions in hospital use, improved patient outcomes, and substantial cost savings for the HSE.
Historically, Letterkenny University Hospital saw 38% of emergency department admissions related to respiratory conditions, with 28.7% of COPD patients readmitted within 30 days — the highest in Ireland. Early project results showed a 20% drop in COPD admissions and a 50% drop in readmissions, and the new evaluation confirms 934 hospital bed days avoided and over €4.2 million in potential savings compared to usual care.
According to Dermot Monaghan, HSE Integrated Healthcare Area Manager, Donegal:
“this is an excellent example of integrated, person-centred care that supports people to live well in their communities while easing pressure on our acute hospitals. The service ensures that people receive high quality care close to their own home and reduces their dependency on GP and Acute Hospital Care. The integrated approach ensures that the highest quality care is in place to allow people to live with a chronic disease and in most cases increase their ability to live their lives to the full which in the very recent past, would not have been possible.”
The CARE Virtual Ward aligns strongly with the Sláintecare vision and the Enhanced Community Care (ECC) programme and further underpins the HSE priorities as stated in the Corporate Plan where seeking to deliver care in the right place, the HSE sets out to “deliver co-ordinated care closer to home, enhance community care, increase support for more older adults and those living with chronic disease” and overall to “increase the amount of care delivered in the community.”