Yahya F, Cooper M, Saif W, Kassem M, Nazar H Development of a Hospital at Home Digital Twin for Patients With Frailty: Scoping Review Journal of Medical Internet Research 2025;0:e0 URL: https://www.jmir.org/2025/1/e81510 doi: 10.2196/81510
What’s this about?
How can we make the most of advanced technology and live information to improve how we deliver hospital-level care at home?
What’s this about?
How can we make the most of advanced technology and live information to improve how we deliver hospital-level care at home?
Why are we looking at this?
The NHS 10-year plan wants to:
- Move more care from hospitals closer to home
- Prevent illness instead of just treating it
- Use more digital tools to support care
What is the work we are doing?
We explore all three by using something called Digital Twins. A Digital Twin is like a live virtual simulation of a patient and their surroundings using real-time information. It can help healthcare professionals predict problems early, to give care that’s safer and more personalised.
Learning from, and working with other experts, our work looked at creating a simple step-by-step model, which can be used to develop a Hospital-at-Home Digital Twin. This review was based on existing evidence for tools to support this, for patients living at home with frailty.
What does this mean?
- Technology and real-time data can help health professionals care for patients at home more efficiently.
- Digital Twins could make care timelier, safer, and tailored to each person.
- We’ve outlined the main building blocks for creating a Hospital at Home Digital Twin.
This work is just the beginning, but it shows how technology could possibly change the world of healthcare and what needs to be worked on to make this possible.
For those that want to know more:
Our article reviews the current evidence for tools that exist to support the development of a Hospital at Home Digital Twin. We describe the 5 layers required to build a Digital Twin. Results show that a variety of technologies exist to pick up information, such as wearables. However more understanding is needed of how we manage that data, store it, translate it and use it to make useful predictions to help staff who are looking after us make decisions. This article also talks about some of the challenges and opportunities we may face when using these technologies in our current healthcare system.
By Dr Anna Robinson-Barella and Dr Matt Cooper
Along with several of our NIHR Newcastle PSRC colleagues, Matt and I attended the SafetyNet symposium on Friday 17th October in Manchester. The focus of the event was: “Tackling Inequalities in Patient Safety”. It was a day that encouraged a lot of reflection-primarily upon patient safety and our cross-PSRC SafetyNet-agenda, but also upon intersectional influences including ethnicity, marginalisation, and wider EDI-related issues underpinning our work.
We heard from speakers across all six of the PSRCs, as well as two keynote speakers, Dr Rosie Benneyworth presenting “Moving away from a “whose to blame” culture” and Prof Dawn Edge presenting “Ethnic Inequalities in Patient Safety”.
NIHR Newcastle PSRC had 32 of our colleagues in attendance; many of whom presented research posters about their work covering topics like polypharmacy, medicines adherence, costs and treatment decisions, social prescribing, health-related quality of life, and predicting diseases by using AI.
It was also a pleasure to personally contribute to the agenda of the day, and represent NIHR Newcastle PSRC, by presenting an evidence synthesis on inequities affecting medicines access for people experiencing homelessness and the subsequent consequences on their (patient) safety.
Congratulations to all the team involved in organising, hosting and running a great symposium!
Making research truly inclusive, equitable, and impactful.
The Culturally Competent Research Framework (CCRF) is a practical toolkit that helps researchers embed cultural competence and equity into every stage of the research journey — from idea to impact.
Developed through an NIHR-funded collaboration, the framework brings together a multi-disciplinary team of academics, community leaders, policy makers, translators, and interpreters. Together, they co-designed an evidence-based, step-by-step guide to make culturally competent research not just an aspiration, but a standard.
Grounded in Meleis’ cultural competence principles — and expanded to include language, cultural humility, reflexivity, and reciprocity — the CCRF offers 25 actionable recommendations and measures you can apply across five key research stages:
1. Formulation | 2. Recruitment | 3. Measurement | 4. Analysis | 5. Dissemination
This isn’t another checklist. It’s a living framework that helps you design and deliver research that truly represents, respects, and benefits diverse communities.
Whether you’re writing a grant, planning a study, reviewing ethics, or sharing findings, the CCRF gives you the tools to make your research more inclusive, credible, and culturally responsive.
Start here. Start now. Make cultural competence the norm — not the exception.
By Prof Hamde Nazar, NIHR Newcastle PSRC
At the PSRC PhD SafetyNet event in March 2024, it became clear that were individual researchers and doctoral students investigating various safety aspects of a model of care known as virtual wards, currently gaining a lot of traction. Virtual wards, or hospital at home is not a new concept, but there has been increased drive to better manage patients in their home to avoid hospital admission and/or facilitate early discharge. Virtual wards allow patients of all ages to safely and conveniently receive acute care at their usual place of residence, including care homes.
After some corridor discussion, Prof Beth Fylan (Yorkshire and Humber PSRC) and Prof Hamde Nazar (Newcastle PSRC) decided to organise a collaborative Virtual Wards PSRC Safety Event.
In September, guest speakers, researchers, doctoral and pre-doctoral students across NIHR infrastructure were welcomed to the cross-PSRC Virtual Wards event in Newcastle University. The aim was to facilitate discussions to identify and develop research priorities and foster partnerships in this area of research.
The day was opened with an informative update by the virtual ward programme lead at NHS England, Charlotte Lynch. Charlotte provided an overview of the current evidence base and newly published Virtual Wards operational framework. It was recognised that there have been priority areas such as frailty, respiratory and heart failure and an increasing focus on children and young people. The national virtual wards team are keen to hear more evidence about what features of virtual wards are associated with positive outcomes and for which patients. There is interest to understand the longer-term impact on patients and establish how patient safety can be measured in this context.
Sophie McGlen then delivered interim findings on the barriers and enablers to implementation of virtual wards across the Midlands integrated care system. Sophie described the many factors across the system, organisation and practitioner levels that are important to consider around virtual ward implementation.
Maggie Westby provided an update on a realist review on virtual wards for patients with frailty. The key take home messages were around having more proactive care, keeping people safe and stable to prevent deterioration and potential crisis.
Representatives from four of the PSRCs (Newcastle, Yorkshire and Humber, Greater Manchester and North West London) showcased patient safety in virtual wards research projects.
Three round table discussions then focussed on:
- Research priorities for patient safety in virtual wards
- Potential methods and strategies to researching patient safety in virtual wards
- How to embed patient and public involvement and engagement and equality, diversity and inclusion into research
Attendees agreed on some key areas that required further evidence. namely:
- Establishing shared definitions and standards for virtual wards
- Investigating data availability, integration, sharing and governance for virtual wards
- Investigating patient safety in virtual wards – understanding appropriate metrics and strategies
- Investigating safe and appropriate patient assessment for and monitoring within virtual wards
- Understanding the need for and nature of workforce training, preparedness and competence
There was an appreciation that evaluations of virtual wards to date have been mainly single-site and observational in nature. There was a consensus that multi-site studies employing robust research designs, experimental where possible, are needed to improve the quality of the evidence base.
All attendees discussed the need for sustainable, well-resourced and diverse patient and public involvement to feed into all stages of the research process.
The final discussions of the day were to establish the next steps for this group given the shared interests and endeavours. There is an intention to set up a community of practice around patient safety in virtual wards where researchers can share, disseminate and signpost evidence and findings. The group are interested to explore the potential for collaboration for research and funding applications.
Researchers interested in joining the mailing list for the community of practice can contact Hamde Nazar from the Newcastle PSRC hamde.nazar@newcastle.ac.uk
Following on from this event, Prof Hamde Nazar has been invited to share the directions of research as identified by the PSRCs at a Virtual Wards sand pit event in October 2025 that is supported by the Advanced Care Research Centre based at the University of Edinburgh, the NIHR Applied Research Collaboration (ARC) North East and North Cumbria and Newcastle University.