A Safer Care Pathway from ICU to Home: With wearable & wireless monitoring

Abstract

Changes in vital signs are often the first sign of patient deterioration and the need for escalation of care. Unfortunately, vital signs are typically recorded not more than every 4-8 hours as the current standard on hospital wards. Early signs of patient deterioration may therefore be easily overlooked. In the past years, wearable sensors for wireless vital signs monitoring have entered the market that could capture patient deterioration sooner. However, for most wearable sensors their validity is unknown. In this thesis, we set out to answer the question whether current wireless sensors are accurate enough to measure vital signs in high-risk patients and whether these sensors can serve as a safety net in day to day care both on a hospital ward and at home in the early days after discharge. To study this, we performed validation studies with a variety of wearable sensors in patients at risk for complications and investigated the feasibility of remotely monitoring surgical patients after hospital discharge in their own home. Most wireless sensors are accurate for heart rate. Respiratory rate is more difficult to measure, but reliable enough to identify abnormal trend patterns before complications are recognized. Remote monitoring of vital signs is well perceived by patients, but it is more difficult to maintain data continuity when patients are monitored at home. Well-functioning technology is only a minor prerequisite for success. Structured contact moments between patients and clinicians, in addition to remote vital signs monitoring functionality, increases the likelihood of successful implementation of remote patient monitoring. If applied well, this development can truly contribute to delivering the right care in the right place.