A Wearable, Wireless Early Warning System for Enhanced ... › asset › 0 › document › 296.pdf · A Wearable, Wireless Early Warning System for Enhanced Patient Outcomes Dr Alison

A Wearable, Wireless Early Warning System for Enhanced Patient Outcomes Dr Alison Burdett

CTO, Toumaz Group

September 2015

1

•  Patient Vital Signs Monitoring – the Healthcare Need

•  SensiumVitals – a Wearable Wireless Early Warning System

•  NHS Deployment – Challenges and Opportunities

-  Building the Business Case

-  Digital Interoperability

Outline

2

Intermittent/Manual Systems

Clinical Patient Monitoring Today

•  Vital signs taken during routine observation rounds every 6-8 hours

•  Method deployed for the majority of hospital patients in general care

Continuous/Automated Systems

•  Patient tethered to the bed/monitor

•  Reserved for high-dependency/critical care patients (<10% of population)

3

The Healthcare Need

•  NICE guidelines for acute patient care (CG50 2007) identified that patients

becoming unwell often receive suboptimal care, primarily due to a delayed

recognition of deterioration and failure to trigger a response from the medical

team.

•  The guidance recommended the introduction of a “track and trigger” system for the

frequent monitoring of vital signs

4

Sepsis

For every hour’s delay in the treatment of Sepsis, the

patients risk of death increases by 7.6%

Its estimated that 33% of bed days are taken up by

patients with Sepsis in the UK

The average cost of treating a patient with Sepsis is

£10,000

The Deteriorating Patient

11% of patient deaths reported to the NRLS were as a result of deterioration not detected or acted upon

Action taken in the early stages can

prevent deterioration progressing to cardiac arrest

60% of deaths, cardiac arrests and unplanned ICU admissions were preceded

by abnormal physiology

5

•  Wearable, wireless monitoring as an adjunct to standard NEWS monitoring, will allow earlier detection of deranged physiology in specific patient groups.

•  Benefits:

-  Less invasive treatment

-  Reduced length of stay

-  Reduced level II/III care

-  Improved patient outcomes

-  Reduced treatment costs

•  Patient groups most at risk of deterioration

-  Post-surgical (colorectal, GI, orthopaedic….)

-  HDU step-down

-  Neutopenic (chemotherapy, burns)

-  Elderly (increased co-morbidities, often non-verbal)

The Benefits of Early Detection

6

•  Patient Monitoring – the Healthcare Need

•  SensiumVitals – a Wearable Wireless Early Warning System

•  NHS Deployment – Challenges and Opportunities

-  Building the Business Case

-  Digital Interoperability

Outline

7

SensiumVitals® Monitoring Technology

•  Wearable, wireless, continuous monitoring for general ward patients

-­‐  heart rate, respiratory rate, axillary temperature

-­‐  patient worn monitoring patch

-­‐  low cost, single patient use to avoid cross infection risk

-­‐  FDA cleared & CE Marked

•  Ultra low power device, near real-time vitals every 2 minutes, 5 day battery life

•  Lightest, most unobtrusive patient monitor on market

•  Clinical evidence for efficacy and cost effectiveness (US study)

8

The SensiumVitals® System

EMR

SensiumVitals Patch

SensiumVitals Bridge

Virtual Server Controls bridges Tracks patches

No patient names

Virtual Server Links patient ID to patch

Notifications via email / SMS User interface (using https)

Connects to ADT & EMR

System

Wireless Monitoring Application

Screen

Notifications sent to

handheld devices

Wi-Fi (802.11) or

Ethernet (802.3)

Proprietary 868/915 MHz

HL7 Messaging

9

Patient Summary Screen

10

Patient Trend Screen

11

•  Notification generated on sustained period

of deranged vital signs (configurable, but

typically 10 minutes)

•  Notification limits can be set on a per ward

or per patient basis

•  Default values are aligned with NEWS

limits

•  Email notification can be forwarded to

phone, pager, tablet etc. as appropriate for

given clinical setting

Mobile Notifications – Taking Data to the Nurse

12

SensiumVitals® – Key Messages

Optimised patient care

• Allows nurses to prioritise patient care

• Provides reassurance to the clinical team and patients

Increased patient mobility

• Patient mobility is key to faster recovery times

• Unique roaming capabilities allow monitoring and mobility

Patient data when and where it is

needed

• Accurate and reliable data every 2 minutes

• Easy integration with hospital information systems saves time and ensures accuracy

Early detection of patient deterioration

•  Proactive notification of change in patient status brings the nurse to the deteriorating patient prompting early clinical intervention

•  Improves patient outcomes, shortens hospital stay, lowers treatment costs

13

•  Patient Monitoring – the Healthcare Need

•  SensiumVitals – a Wearable Wireless Early Warning System

•  NHS Deployment – Challenges and Opportunities

-  Building the Business Case

-  Digital Interoperability

Outline

14

NHS Procurement & Deployment is Complex!

Lead Clinicians Senior Nursing Teams

CFO, CTO, CEO Nurses

Outreach teams Clinical Informatics

Innovation Biomeds

Patient safety teams Hospital IT

Programme Managers Purchasing

Charitable Fund Holders Patients

External Parallel Stakeholders

Pager Companies

Phone Suppliers

IT Services

Government Legislators

Enablers of Automation

Non Local Decision Makers

Innovation Organisations

GPOs

External Fund

Holders

Medical Societies

KOL’s

Patient Organisations

15

Clinical Benefits and Cost Savings Must be Demonstrated

Installation time & cost

Ongoing purchase price

Nurse training

Workflow changes

=

*US trial indicated average LOS reduction ~4 days, costs savings $5.5K, for deteriorated patients

Better patient outcomes

Reduced costs through:

•  Lower LOS

•  Fewer HDU readmits

16

Health Economics Trial Data Comparative Data Trial Data

Notifications Received and Resultant Intervention

Deteriorations and interventions in the pre-trial period (typ. 30 days)

Notification reason; notification time; time until next manual obs; intervention given

Length of Stay Average LOS for the patched ward LOS for each patient (on ward & in hospital)

HDU Referrals Number of referrals to HDU in the pre-trial period

HDU referrals from the ward during trial period

Number of Patients put on the Sepsis Pathway

Number of patient put on the sepsis pathway in the pre-trial period

Patients on the sepsis pathway during trial period

Patient Satisfaction Current level of complaints made to PALS about this ward in the pre-trial period

Level of complaints to PALS during trial period; direct patient feedback

Nurse Feedback & Compliance Nurse feedback; # of patched

patients meeting trial criterial

17

•  Patient Monitoring – the Healthcare Need

•  SensiumVitals – a Wearable Wireless Early Warning System

•  NHS Deployment – Challenges and Opportunities

-  Building the Business Case

-  Digital Interoperability

Outline

18

Digital Interoperability – Challenges

email

EPR

PACS

e-Prescribing

e-Obs

SensiumVitals

19

•  Hospital benefits:

-  Single login for users

-  Single ‘point of care’ mobile device

-  Notification and audit trail incorporated into existing, familiar systems

-  Hospital can select ‘best of breed’ for e-Obs, EPR, e-Alerts etc.

•  SHC benefits:

-  Company can focus efforts on key USP (wearable, wireless, disposable vitals signs monitoring)

-  Simpler deployment, as partner manages ADT feed, Active Directory interface, etc.

-  Interoperability partners have pre-installed customer base

Digital Interoperability – Opportunities

20

– a Secure, Audited Messaging Platform

21

Data Available Remotely through Secure Mobile Platform

22

Future Interoperability Partnerships

23

Interoperability with the Patient?