‘In-hospital’ patient tele-monitoring program devised at UHN
September 27, 2019
TORONTO – A system that improves safety and saves money is a home run for a hospital, and University Health Network’s Patient Tele-Monitoring Program has managed that feat.
The system was developed to address a rising expense: patient sitters. These people provide personal, around-the-clock observation, intervening and preventing patients from accidentally injuring themselves through falls, removing lines, or not following through their treatment plans.
To address the rising number of adverse post-surgery events in vulnerable patients, UHN and other North American hospitals have been increasing the use of sitters in recent years. Although effective at reducing the number of adverse events, direct personal patient observation is a rapidly growing financial burden on Canada’s healthcare. It calls for a technology-backed alternative.
Working closely with the Sprott Department of Surgery, UHN’s Techna Institute designed, built and successfully implemented innovative technology to provide 24/7 remote observation of patients at risk for adverse events.
This first-in-Canada Patient Tele-Monitoring Program allows a two-way communication between a trained tele-monitor technician and up to six patients at a time from outside their hospital rooms.
Using off-the-shelf hardware for its mobile camera units, speakers and microphone, paired with an embedded Linux system, the server can determine camera names, IP addresses, and video encoding formats.
The Tele-Monitoring application can connect to the cameras, and the person observing can set up a layout to monitor multiple patients simultaneously. Overlays of the patient’s name, site, floor, room number, and call information to dispatch help are displayed in an overlay for each video source.
The remote observer can associate each patient’s video feed in the software with a nurse and dispatch number so that a call can rapidly be placed, when needed, with a “touch-to-call” icon in the application.
When a patient moves, the motion detector sends notifications through a computer to the technician, providing a back-up to the human vigilance of the operators.
The system allows the technician to verbally direct the patient to keep their treatments in place or stay in their bed if getting up by themselves is unsafe. The technician can also rapidly make a dispatch call through touch-based interaction, with the patient room and event displayed in the touched video feed.
Integrated within the UHN network, the program has been implemented across the Toronto General and Toronto Western Hospitals, as well as at the Princess Margaret Cancer Centre, and has received rave reviews from its users.
The efficiency of having one full-time technician over six sitters on an on-call basis has saved hundreds of thousands of dollars in operating expenses and has also improved the predictability of the expense.
While UHN is targeting a 60:40 mix of in-room and remote observation, some units have already transitioned 80 percent of their cases to the new system, while maintaining a high level of patient safety.
Dr. Shaf Keshavjee, surgeon-in-chief at UHN and the clinical lead and sponsor of this project, said “the Telemonitoring Program at UHN has not only developed advanced and innovative technology to improve patient safety, but has also led to savings in the cost of constant monitoring of patients at risk.”
With the cost of bedside sitters constantly increasing, the Patient Tele-Monitoring Program has shown a significant reduction in sitter-associated healthcare spending, without compromising patient safety. To help other hospitals with this challenge, the Techna Institute is leading UHN’s activities to disseminate the technology and clinical processes.
Marijana Zubrinic, RN, MScN, NP, Leads the UHN Telemonitoring Program; Luke Brzozowski PhD, is Senior Director, TECHNA Diagnostics and Technology Innovation.