Patient Monitoring Moves Beyond Hospital Walls

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Patient monitoring technology is evolving to enhance immediacy, accuracy and ease of access with an added dimension of intelligence—to predict, monitor and analyze patient events over time—and flexibility—to monitor patients from other areas in the unit and even the patient’s home.

Self-monitoring

“Hospitals have a financial impetus to make certain that a heart failure patient doesn’t get readmitted after discharge within a 30-day period,” says Karen M. Garfield, RN, director of clinical development at Suncrest Home Health in Madison, Tenn. Suncrest uses Philips Healthcare’s Telehealth Solutions, which includes a telestation and devices to record blood pressure, pulse oximetry and ECG to assist patients in their homes across Tennessee and Florida.

On a daily basis, these patients take vital signs and send the information to the tele-station through wireless technologies. The telestation prompts a series of questions, allowing vital signs and survey data to be uploaded to a web portal, which a clinician can access to view a digital dashboard of the patient’s clinical data.  

Across the U.S., Benefis Spectrum Medical, an affiliate of the Great Falls, Mont.-based Benefis Health System, purchased 26 Intel Health Guides last year for their patients to use in their home. Benefis serves patients across a six-county area of north-central Montana covering 24,000 square miles. Patients with chronic conditions, such as congestive heart failure, obstructive pulmonary disease, asthma, hypertension and diabetes, use Health Guide to self-monitor, says Teresa O’Connell, RN, manager of clinical services. The Health Guide’s web-based system connects patients and their healthcare teams via broadband, cellular, wireless and residential phone service.

The Health Guide’s trending capabilities let clinicians review their patients’ progress, with a goal to anticipate or prevent hospitalizations. For example, when one patient’s oxygen saturation strayed from acceptable parameters, Benefis saw the change and notified the primary care physician. “The patient hadn’t gotten up to take her medications or use her nebulizer because she felt poorly,” says O’Connell, adding that the remote monitoring prevented a potential rehospitalization.  

Smart phones ring in

The smart money is on smart phones to empower patients to be more proactive with their health. The Washington, D.C.-based Deloitte Center for Health Solutions says that a personal health record (PHR) embedded in mobile communication devices—or mPHR—may change the game for providers, patients and payors.

Devices such as smart phones and mobile tablet PCs are relatively inexpensive, portable technologies that can collect environmental and patient-centered information for transmission via the internet to a PHR. Combined with decision support tools, the mPHR can analyze aggregate data to activate mobile, patient-specific output such as medication reminders and healthy habit tips.

“With growing recognition among policy makers, health plans and providers that the key to reduced healthcare costs and improved population-based outcomes is more effective consumer self-care, the mPHR is positioned as a natural progression of technological capabilities to help achieve this desired future state,” according to a report from Deloitte.

The potential of smart phone information sharing has spurred the 11-hospital Memorial Hermann Healthcare System, based in Houston, to adopt the AirStrip OB (Airstrip Technologies) application. It allows physicians to remotely view waveforms of uterine pressure contractions and fetal heart rate in real time using a variety of smart devices. Data are sent to a central server, where clinicians can quickly access the information, says M. Michael Shabot, MD, Memorial Hermann’s chief medical officer. Clinicians can make notations from their phones and send these messages to other clinicians.

As the worlds of mobile communication devices and patient monitoring continue to evolve, they will be further integrated, allowing more patients to remain out of the hospital and more hospitals to meet government mandates for fewer readmissions.