The Oxford University-RAND Europe centre for rapid evaluation of technology-enabled remote monitoring: DECIDE (Digitally Enabled Care in Diverse Environments)

Background: There is growing interest in technology-enabled health and social care, including in the use of remote monitoring. The aim is to respond to system pressures and improve access to, experience and quality of care. However, technology-enabled remote monitoring interventions are fairly new, with limited evidence about impact.

There is an urgent need for process, outcome and impact evaluations of interventions at various stages of development and implementation to address questions around adoption, spread, sustainability and inequalities.

Aim: NIHR is funding a 3-year team to conduct rapid evaluations in this field. The Oxford-RAND Europe centre for rapid evaluation of technology-enabled remote monitoring is known as DECIDE (Digitally Enabled Care in Diverse Environments). Through evaluative evidence generation and shared learning, it aims to support service users, service commissioners and providers of remote monitoring services, to enable high quality care.

Patient and public involvement and engagement (PPIE): A Service User panel with diverse voices will help shape evaluation design, implementation and dissemination. This includes institutional members and – at project level - those with lived experience. We are working with our PPIE lead and wider team, who are also be supported by a steering committee of experts in health and care services, policy and service innovation.

Approach and methods: DECIDE brings together expertise and a proven track record in health and care innovation- including adoption, spread and scale up, technology-enabled health and care, methodologically robust and rapid evaluations, prioritisation, co-production and stakeholder-engagement.

Focused questions and evidence needs will emerge for each evaluation and be informed by established contributions to the theory and practice of understanding Non-Adoption, Abandonment and the challenges to Spread, Scale-up and Sustainability of technological innovation in health and care (NASSS framework). Each evaluation includes set-up/scoping, main implementation and synthesis phases. Qualitative, quantitative and health economics methods will inform evaluations. Example questions are:

• Is the technology-enabled remote monitoring innovation needed, and if so, by whom?

• How does it work and what factors relate to the intervention, implementation process and wider context influencing adoption? • What are associated outcomes and impacts, and on whom?

• How does the intervention and its impacts mitigate and/or tackle inequalities and wider equality, diversity and inclusion considerations? • What are the opportunities and challenges for scale and spread? • What de-implementation considerations matter?

Impact and dissemination: An overarching dissemination and impact strategy will be co-produced with steering committee and service-user input. Project led dissemination and impact and learning across evaluations (e.g. on topics, methods) will provide timely and rigorous insights to inform decision making by policymakers, commissioners, providers, patients/service-users and researchers. This involves:

- formative and summative communications - tailored outputs to different audiences and contexts - at least one significant patient/public led output

- a mix of written, visual, audio and verbal activities (e.g. journal outputs, policy briefs, webinars, case-vignettes, infographics, blogs, conference dissemination) - in-person and virtual engagements