The HOTEL multicentre study has the potential to transform remote obstetric care. Groundbreaking research on the benefits of remote CTG monitoring has been published in The Lancet Digital Health in 2023.

The study shows how home monitoring of high-risk pregnancies can: 

  • Produce comparable outcomes against in-hospital care
  • Increase patient satisfaction
  • Reduce costs

The post-COVID era presents new challenges for healthcare, highlighting the need for technological innovation and changes in patient care processes. However, the shift to remote care brings up concerns about maintaining the quality of clinical information and care compared to traditional methods.

To address these concerns, six Dutch hospitals collaborated on a study to compare remote CTG monitoring with in-hospital monitoring. This multicentre, randomized control trial involved 200 high-risk pregnancies and aimed to determine if remote monitoring does not present additional risks to mother and fetal health.

“In conclusion, our findings suggest that home telemonitoring in pregnancy care is an acceptable alternative to monitoring selected pregnancies with complications, with a reduction in costs and higher patient satisfaction, and therefore has potential to reduce admissions and costs in obstetric care.”
 

Participants requiring daily monitoring were randomly assigned to either a telemonitoring group or a hospital monitoring group. Those in the telemonitoring group went home with specialized equipment, including cardiotocography and blood pressure devices provided by ICT HCTS. These devices wirelessly transmitted data to hospital experts for evaluation. Patients in the hospital monitoring group received standard care on the ward.

The primary focus of the study was to evaluate the occurrence of adverse perinatal outcomes after delivery, comparing the results between the two groups to ensure the safety and effectiveness of remote monitoring.

“Adjusted for centre of inclusion, diagnosis, and nulliparity, the risk difference in primary outcome between both groups was 10·3% (95% CI –22·4 to 2·2) lower in the telemonitoring group.”

Findings

The key discovery of this trial was that home monitoring can be safe for high-risk pregnancies.

Telemonitoring groupHospital admission group
Participants100100
Adverse primary outcomes3140

Cost of care in the study was also favourably impacted by home monitoring, and patient satisfaction was increased.

Conclusion

During a time when patients are especially vulnerable and need both comfort and compassion, and as healthcare workloads, demands, and costs continue to rise, it's reassuring to know that effective alternatives exist. Remote monitoring offers a viable solution to maintain high-quality care while also reducing costs and enhancing patient satisfaction.

To learn more about the HOTEL study, visit this page on the UMC Utrecht website (in Dutch).
 

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