UHN staff monitor Winnipeg patients via telehealth

WINNIPEG – A new pilot project at HSC Winnipeg is using innovative technology to remotely monitor medically appropriate patients, helping to reduce falls and other adverse events by installing an IV-pole-sized portable camera and audio unit at the patient’s bedside. The Halo telemonitoring program, in partnership with Toronto’s University Health Network (UHN), sees medically appropriate patients monitored remotely 24 hours per day, seven days per week by trained UHN telemonitoring technicians through a secure livestream.

Dr. Shawn Young (pictured), HSC Winnipeg’s chief operating officer, told CTV News Winnipeg the hospital must get creative.

“It is our way forward through this,” Dr. Young said.

“We have a tremendous backlog of patients that we have got to be able to serve and we just can’t do it with the staff we currently have. We are going to be short for many years. This staff shortage isn’t something that is going to be solved immediately, it’s going to be very slow incremental work.”

In addition to monitoring patients who are at risk of falls, telemonitoring can be used on patients who have the potential to harm themselves or others, persistently wander or are a flight risk, require high oxygen flow or are unable to alert staff for assistance due to physical limitations, cognitive changes or environmental factors.

“Telemonitoring is a safe and innovative way to care for patients that other jurisdictions have successfully used to varying degrees,” said Dr. Young. “We are pleased to be the first hospital in Manitoba to trial the use of telemonitoring technology and anticipate this program will free up valuable clinical resources to provide direct care to patients while ensuring the continuous care needs of patients are met.”

Telemonitoring can offer several benefits for patients and their families, including quickly identifying changes in their condition and redirecting inappropriate or harmful behaviour.

“Telemonitoring has been a great opportunity to use technology as a way to enhance the care we provide to patients,” said Morgan Stalker, clinical resource nurse at HSC. “It allows us to keep our patients’ safety a priority and give peace of mind to their families while freeing up bedside staff to provide more hands-on patient care.”

The Halo program will be used on two inpatient units at HSC Winnipeg over the next nine months on a trial basis, with patients selected based on medical appropriateness to ensure their care needs can continue to be safely met. The program has been successfully adopted in hospitals across Canada, in addition to all inpatient units at UHN facilities in Toronto.

The UHN’s Patient TeleMonitoring Program was created several years ago by clinicians, staff and engineers at the hospital who saw an opportunity to replace costly, overnight, bedside sitters for patients experiencing delirium and confusion.

“We were spending $3.8 million each year on bedside sitters who sat by patients to ensure they didn’t engage in harmful behaviour, like trying to climb out of bed before they were ready, pulling on invasive lines or taking their oxygen mask off,” said Marijana Zubrinic, a nurse practitioner at Toronto General Hospital.

“Bedside sitters are an important service, but the model at the time was not sustainable from a financial perspective.”

So in 2016, funded by the Sprott Surgery Innovation Fund, Zubrinic partnered with the Techna Team to develop a remote monitoring service, comprised of a portable camera and two-way microphone unit, that allows one care provider to see, hear, and talk to up to eight patients at a time, across all sites at UHN, from a monitoring station on the 10th floor of TGH.

Eighty percent of the time, TeleMonitoring can be effective in redirecting patients. When it can’t, the technician will call the primary nurse of the patient, who has been equipped with a phone, to help.

The area where it’s made the biggest impact is in UHN’s Lung Transplant Program, where patients with high oxygen needs were either removing their masks in confusion, or masks were coming off, while they slept, increasing the risk of respiratory arrest.

“We found that by gently prompting patients to put their masks back on, incidences of preventable death for these patients dropped significantly,” said Zubrinic.