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PAT I ENT DET E RIORATION


warning scores to help ensure patients who are deteriorating, or at risk of deteriorating, have a timely initial assessment by a competent clinical decision maker. Ultimately, this has the potential to improve outcomes. By automating the early warning score and vital signs recording, nursing time is also freed, leading to efficiency gains. “The NHS was already experiencing chronic staff shortages prior to the pandemic, but with many nurses off sick, due to the coronavirus, and an increasing number of COVID patients being admitted, these efficiency gains have become even more invaluable,” Errey commented. Observations taken include heart rate, respiration rate, temperature, oxygen saturation levels, ECG and blood pressure. Nurses can also input the patient’s consciousness score, while the system captures each and every heartbeat, and change in rhythm. “The clinicians we are currently working with believe this close analysis of the heart rate could be valuable in detecting sepsis or whether the patient is going through a Cytokine release storm. Symptomatically, these can look the same but, in terms of treatment and physiology, they are very different,” Errey revealed.


Based on their early warning scores, the patients most at risk are shown at the top of the screen, enabling staff to prioritise interventions according to clinical need. Isansys is also working with a hospital site in New York on next generation technology that enables patient data to be delivered to clinicians’ mobile devices to alert staff of patient deterioration and allow them to prioritise what they wish to view in relation to an individual patient. “This mobile, early warning alerting system will interface with the patient’s medical record and offer a real-time view of the patient’s physiology, while also looking back over their history, medication and prior- conditions – enabling the system to provide a very accurate judgement on what the patient may need next, as a treatment. Ultimately, it is all about the data. Once you have the data, you can really start to advance patient care and improve outcomes.”


The PSE is not an intensive care system, but the system facilitates the provision of a high dependency bed by providing continuous monitoring without having to install large volumes of equipment. “Any bed can essentially become a high dependency bed and be managed remotely,” Errey commented.


The system enables hospitals to quickly build up a complete data set about an individual’s personal health status. Once you have this, you can start to look at a range of AI or deep learning algorithms, which can proactively predict what is going to happen to the patient in the future.


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The speed in which this can be achieved, using the PSE system, has enabled hospitals to quickly respond to escalating demand during the pandemic. “Once the basic IT infrastructure is installed (which takes less than half a day), you can just add the monitor next to the bed and put the wireless sensors on the patient,” he explained.


The open architecture of the system makes integration of the patient’s vital signs into the electronic patient record, as straight forward as possible. NHS sites are currently viewing the data via Isansys screens and their own screens but, in the future, these screens will be combined. “This is a relatively straight-forward task but requires careful management – due to fast escalation of the pandemic, there hasn’t been time to undertake this engineering, but this will soon follow,” Errey reported. He added that the technology has made


SEPTEMBER 2020


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