The smartphone: an evolution or revolution in virtual patient healthcare during and beyond the COVID-19 pandemic ? An evaluation and comparison of the smartphone against other currently available wearable technologies in a secondary care setting during the COVID-19 pandemic.

Smartphones are now commonly used, for virtual outpatient consultations, to help reduce disease transmission during the COVID-19 pandemic. Nosocomial spread of COVID 19 and hospital acquired infections are usually from staff or students to patients. Reducing non- essential staff numbers on ward rounds may reduce the risk. We describe the novel use of smartphones, with Microsoft Teams, to live stream inpatient interactions, radiological images, pathology results, charts and patient review between an office-based and ward team (virtual ward round) and for teaching medical students in secondary care. After Research and Ethics, Digital services and Information Governance approval we compared a smartphone and head-worn device (Realwear HMT-1). Data collection was by participant questionnaire. Statistical analysis was performed using the Mann - Whitney test. There was no statistically significant difference in audio and video feed quality between the smart phone (p value = 0.3) and Realwear device (p value = 0.41). However the smartphone was preferred during ward rounds and was 85% cheaper than the Realwear device. Urology medical staff numbers on the ward were reduced by 50%. Ward round efficiency improved as administrative tasks could be performed by the office team during the virtual ward round. Virtual ward rounds using smartphones can facilitate remote communication between staff, students and patients. Staff in isolation or shielding can also assist front line colleagues from home. Smarter use of the smart phone may help reduce staff numbers on wards and reduce the number COVID-19 and nosocomial infections, potentially reducing morbidity and mortality locally and globally.