When Tagreed Almuhnna sought medical help for her son, who has attention deficit hyperactivity disorder (ADHD), she expected a face-to-face consultation with a doctor. Instead, 11-year-old Abdulmalik received treatment from a psychologist and paediatric psychiatrist through a groundbreaking ‘virtual hospital’ in their native Saudi Arabia, with the treatment taking place entirely through a video screen. Initially the child struggled to engage with the clinicians remotely, but after several sessions he had adapted to the format and his condition had much improved. Speaking through an interpreter, Almuhnna says she would not have been able physically to access such high quality care in her own area. She is now a firm convert to an approach which is starting to take root around the world as health systems struggle with constrained resources and staffing shortages. Virtual wards – in which a limited number of patients are monitored at home via sensors and other equipment – have become increasingly common in health systems. But Seha Virtual Hospital in Riyadh, under whose auspices Abdulmalik was treated, has adopted this approach on a grand scale and has been recognised as the world’s biggest virtual hospital by the Guinness Book of Records. Mona Sahman Al-Subaie, chief executive, says the facility had been established as part of a broader plan to improve the health of people in the Kingdom. She says that it offers solutions to challenges including ‘geographical distances, the lack of specialised resources, the high cost of healthcare and trying to improve the experience of the patients’. The idea was in part born out of the pandemic, when the Kingdom’s first telemedicine platform was introduced to allow patients to receive medical advice in their homes, without the need to travel. After that technology had proven its worth, the full-blown virtual hospital was launched by the Saudi ministry of health in 2022. It now works with 224 traditional hospitals, offering patients access to remote expertise in 44 specialised services, including cardiology, critical care, neurology and psychiatry. Abdullah Al Wabel, the hospital’s chief medical officer, says most non-urgent cases can be managed completely virtually. The bigger challenge is urgent care, he adds, where Seha’s clinicians work with its partner hospitals to treat patients who have suffered emergencies such as heart attacks or strokes. One side-benefit has been the transfer of knowledge that has occurred between the Seha clinicians and their counterparts in the bricks-and-mortar hospitals, he notes. Rigorous protocols have been put in place to maintain the quality of care, he adds. In devising clinical governance and key performance indicators, they had to start from scratch because there were no precedents to draw on. ‘One of the major challenges that we faced when we established the hospital was there was no clear benchmark [for quality]. There was some clinical governance for services, but not for a complete virtual hospital,’ he explains. Bupa, the UK-headquartered international private health group, is also beginning to adopt aspects of the virtual hospital approach. This summer it will open Blua Sanitas Valdebebas Hospital in Madrid, which it claims will bring together ‘the best of physical and digital healthcare’. This will include digital check-ins and virtual consultations with surgeons before admission, and ultrasounds carried out at home. Virtual medical care will also be extended beyond discharge through personal post-operative plans in which patients’ recovery will be monitored via digital technology. For now, at least, surgery must be carried out in the hospital, says Dr Anne Lepetit, chief medical officer for Bupa Group, ‘although who can guess what is going to happen in 50 years’, she adds. Lepetit argues that the way forward for healthcare lies in just this type of hybrid approach. In her view, it is part of a natural evolution from the development of more sophisticated surgical procedures which allowed many more operations to be carried out as day cases in the 1980s and 1990s. ‘It’s a whole journey that started 40 years ago. And the journey is moving, because technology is moving,’ she argues. Among the patients most likely to gain from the approach, she suggests, are people living with chronic disease, who would benefit from continuous monitoring; those recovering from surgery; rural communities with limited access to specialists; elderly and high-risk populations who need remote home care; and immunocompromised patients, such as those undergoing chemotherapy, which could now be delivered at home. The most expensive accommodation in town is the hospital: it’s $1,000 a night. In Ireland, the approach is also yielding results. Derek O’Keeffe, a Galway-based consultant physician and professor of medical device technology, describes himself as a ‘physicianeer’, a term coined in the US for those like him who are dual-qualified as engineers and doctors. His interest in digital health was sparked by a period working for the space agency Nasa on remote health monitoring of its astronauts. The advent of the pandemic, when access for patients became far more restricted, meant his skills and perspective were suddenly in high demand. O’Keeffe’s projects include a virtual hospital on Clare Island, off the west coast of Ireland, which uses AI and remote monitoring to manage chronic diseases such as chronic obstructive pulmonary disease (COPD) and heart failure for patients who would otherwise have had to take a ferry to the mainland to receive care. It is a joint initiative between the University of Galway and the CÚRAM Research Ireland Centre for Medical Devices, with technology provided by Cisco. Pointing to the savings to be made by reducing the numbers admitted to hospital, he says: ‘The most expensive accommodation in town is the hospital: it’s $1,000 a night.’ He highlights the case of Frank, who is living with COPD and had been spending around one week each month in hospital due to regular flare-ups of his respiratory condition. ‘I looked at that [history] and I thought, surely it would be worth it to put a monitor on Frank and check on him every day or two and see how he’s doing, and if he starts to deteriorate, intervene earlier,’ he recalls. For O’Keeffe, Frank has come to symbolise the value of the approach, in terms of both budgetary savings and patient wellbeing. ‘Since last April, when we started the project, he hasn’t been in hospital one day,’ he adds.

‘Virtual hospitals’ deliver home treatment to remote patients

The article discusses the rise of 'virtual hospitals' that deliver remote medical care to patients, particularly in remote areas. It highlights the success of Seha Virtual Hospital in Riyadh, Saudi Arabia, which has been recognized as the world's largest virtual hospital. The facility offers remote expertise in 44 specialized services and has significantly improved patient care for conditions like ADHD, ADHD, and chronic diseases. Bupa and other healthcare groups are also adopting similar models, emphasizing the potential of hybrid digital and physical healthcare solutions.