Where Are the ‘Dots’?
Remote Monitoring Showcase
Where Are the ‘Dots’?
A network is comprised of nodes, sometimes called dots, that have to be connected for the system to provide benefits.
When you design a network, you want to connect the nodes or devices—“connect the dots”—to be sure that the units that have to “talk” to one another do so efficiently. If a node drops out, due to loss of power for example, there should be a way to route the data around the blacked-out dot and maintain the network’s throughput. If a node moves out of range, you want to know where it went and why.
What if you can’t find one of the dots to connect it? This is a common problem with wireless networks that monitor devices that are portable. If the node is a laptop on a crash cart, and the cart is rolling down the hall to an emergency, you want to be sure the network knows where it is at all times. If you lose connection, you can lose data—and possibly even the patient.
By early 2012, Americans will use about 15 million wireless health-monitoring devices, according to a forecast from ABI Research, which tracks mobile technology trends. The mobile health market is projected to more than triple to $9.6 billion in 2012 from $2.7 billion in 2007, according to study from Kalorama Information Inc.
Remote monitoring devices are far-ranging in their mobility, not constrained by hospital walls or even geographic restrictions. A cardiac monitor can be sending data from the patient’s home one hour and the golf course the next, with a flight to Spain in the future. Disconnected from the network that is monitoring it means delays in responding to the outputs that indicate a change in condition. And that could be fatal.
Obviously, not all of these devices will be confined to a hospital’s environment, but those that are must be consistently monitored. In a test program, a clinical warning system that uses wireless sensors to track the vital signs of at-risk patients is undergoing a feasibility study at Barnes-Jewish Hospital in St. Louis.
The fully operational system will have sensors that take blood oxygenation and heart-rate readings from at-risk patients once or twice a minute. Data will be transmitted to a station where it will be combined with other data in the patient’s electronic medical record, such as lab test results. The vital signs and data in the medical record will be continually monitored by the system to determine signs of clinical deterioration. Any such signs will result in the system calling a nurse on a cell phone to check on the patient.
While several classes of patients can be expected to be mobile, at least one class shouldn’t be: newborns. The smallest and most fragile of the hospital’s clients, infants must be monitored in many ways and one of the most important is by location. Newborns are not supposed to be wandering around the building!
“Our system is called the Hugs system,” explains Steve Elder, senior communication specialist for Stanley Healthcare Solutions. “Hugs is the most widely deployed system for protecting newborn infants from the threat of abduction while in hospital. They wear a small tag, on the ankle typically, which is monitored by the system. There’s a network of receivers in the maternity ward or OB ward and if somebody attempts to remove the tag or to remove the infant from the unit or tamper with the tag in any way, there’s an alarm in the system.”
Babies aren’t the only fragile patients to be monitored. It’s very common for patients post-surgery to be confused and attempt to get out of bed without assistance, which can be dangerous. They’re prone to falling, which can be extremely costly for the hospital because CMS no longer compensates for hospital falls because they feel they are preventable.
Fall monitors are a very well established application. “Basically, ours is a pressure sensitive mat that, when the patient attempts to rise, causes an alarm. This can be either a local sound alarm or routed through the nurse call system to provide remote notification and thus relieving the caregiver from having to physically sit with the patient.”
Whether remote monitoring devices are nodes on the hospital’s network or a dot tracked by a cellular network off site, keeping the data flowing is vital and companies like Stanley Healthcare Solutions are working to make sure that continues to happen.
Tom Inglesby is an author based in southern California who writes frequently about medical technologies.