Patient monitoring
than 95% to be sufficient. With mWear, patients can be observed walking, while monitoring blood oxygen parameters in real-time, for a more accurate evaluation of the patient’s progress. Exercise and recovery plans can then be adapted more effectively based on the patient’s individual needs. The BP cuff is not expected to be worn all of the time (although it can be if required). This is secured to the arm, much like a jogger’s smart phone pouch, and the data is sent back to the smart device. Monitoring temperature is particularly important for ensuring normothermia in surgical patients – before, during and after surgery – as there is a greater risk of surgical wound infection if patients become hypothermic. Similarly, if a patient has a fever, then continuous monitoring of body temperature and blood pressure can help clinicians intervene earlier against conditions such as postoperative septic shock. The technology enables continuous temperature monitoring via a wearable patch on the skin, which is transmitted back to the smart device. It is also compatible with a spot check ear thermometer (iThermometer). The temperature reading can be transmitted via Bluetooth or WiFi back to the main central monitoring station (CMS) and, if the patient is within the community, the kit can be connected via a smart phone. The wearables technology integrates with a portable patient monitor that has a long battery charge of 48 hours (the batteries can be swapped in and out for continuous monitoring), but the modular system can also be plugged into a conventional bedside monitor if preferred. The ePM Modular system has the added
feature of intelligent multi-parameter alarm analysis to reduce false arrhythmia alarms and promote the accuracy of heart rate and pulse rate, while helping to alleviate alarm fatigue – a recognised human factors challenge in healthcare settings. The ability to connect wirelessly to a CMS also helps maximise the use of staff resources – a large number of patients can be monitored simultaneously, which is an important factor in light of recent pressures on the healthcare system. The CMS Early Warning Scores (EWS) dashboard provides an intuitive display of patient status, with dynamic
updates pushed to the mobile viewer – alerting caregivers to changes in patient conditions and potential risk of deterioration. David points out: “Staff-to-patient ratios on general surgery wards are less intensive compared to ITUs, so the technology offers an extra layer of safety and oversight. With the CMS, staff can monitor the condition of multiple patients, not only from a physiological perspective, but also their ambulatory status. “Staff can view multiple readings, at a glance, but the screen can also be set up to focus on an individual patient. The clinician can see if they are up and mobile (indicated by a ‘green man’ icon); a blue ‘lying man’ indicates that a patient is resting in bed, or a ‘red falling man’ alerts staff of the need to quickly respond to a falls incident, which is especially useful for elderly patients.”
Wearables: supporting virtual wards For home monitoring, the EP30 ‘watch’ is compatible with an Android based App and a complete kit of accessories is provided to the patient. The system does not use the patient’s own phone, but a device supplied by the healthcare provider. The technology automatically uploads the measured parameters to the App and transmits this data back to the central station. In addition to the growing number of ‘hospitals at home’ or ‘virtual wards’ managed by hospitals, there are also a growing number of third-party providers that use their own software and transmit data back to GPs. Mindray’s technology can link into this software. “The UK has already seen the success of community monitoring of insulin in people with diabetes, using wearables. The use of mobile technology to manage a variety of conditions in the community will be a huge growth area. There is now significant funding available to support this and the NHS wants to quickly take advantage of this technology before the Winter flu and COVID season takes effect. The scale of the roll out will be interesting and challenging,”
34
www.clinicalservicesjournal.com I September 2023
commented David. Some of the challenges that need to be addressed include the fact that “no two virtual wards are the same”; some form of national standardisation may be helpful, David believes. To ensure the smooth implementation of
virtual wards, there will also need to be a discussion around the best approaches to connectivity, integration with electronic patient records, and asset management of the kit in the community (to reduce losses of assets). While the wearables and mobile devices can be traced and located via their signals, EBME departments will need to have effective systems in place for managing the equipment in the community.
Conclusion Ultimately, David believes that the significant benefits of managing patients at home will far outweigh the risk of attrition with regards to asset inventory – from a financial, operational and outcomes perspective. Wearable patient monitoring will be key to supporting the Government’s ambitions for more efficient models of care, including the scaling up of virtual wards across the UK. “However great your local hospital is, we all
want to be at home. Hospitals want you to go home. Clear guidance on identifying the right type of patients for a virtual ward is important, but this technology will help keep patients safe. We are ready to support the NHS on its journey towards transformation,” he concluded. CSJ
Reference 1. Accessed at: https://transform.england.nhs. uk/key-tools-and-info/data-saves-lives/ improving-individual-care-and-patient-safety/ virtual-wards-relieving-pressure-on-the-nhs- while-caring-for-patients-at-home/
2. Tazreean R, Nelson G, Twomey R. Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements. J Comp Eff Res. 2022 Feb;11(2):121-129. doi: 10.2217/cer-2021-0258. Epub 2022 Jan 20. PMID: 35045757.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76
