The Patient Tele-Monitoring Program Story

1024 768 Techna

To address the rising number of adverse post-surgery events in vulnerable patients, UHN and other North American hospitals have introduced the bedside sitter role: a person who provides personal, around-the-clock observation. Someone who sits in the patient’s room, ready to intervene and prevent patients from accidentally injuring themselves through falls or not following their treatment plans. Although effective at reducing a number of adverse events, direct personal patient observation is costly and is a rapidly growing financial burden on our health care budget, calling for a technology-backed alternative.

Working closely with the Sprott Department of Surgery at UHN, Techna has designed, built and successfully implemented a technology solution to provide 24/7 remote observation of patients at risk for adverse events. Dr. Shaf Keshavjee, Surgeon-in-Chief at UHN and the clinical lead and sponsor of the project stated that “the Telemonitoring Program at UHN not only developed advanced and innovative technology to improve patient safety, but also led to savings in the cost of constant monitoring of patients at risk.”

The 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. A motion detector sends notifications through the monitoring computer to the technician, allowing them 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 dispatch calls 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 multiple sites: Toronto General Hospital, Toronto Western Hospital, and Princess Margaret Cancer Centre, with rave reviews from its users. It is already saving operational dollars for the hospital, and a significant reduction in the staffing hours needed for patient bedside sitting – while maintaining a high level of patient safety.

At the onset of the COVID-19 pandemic the Techna team began to rapidly develop and expand the capabilities of the Tele-Monitoring Program to assist frontline workers and improve clinical outcomes. Covid-positive patients are at risk of rapid respiratory deterioration and sudden death, indicated by a decrease in their oxygen saturation (O2 sat). Frequent visits by clinical staff to monitor O2 sat levels increases their risk of exposure and depletes a diminishing supply of scarce PPE. To solve these critical challenges, an additional Tele-Monitoring camera is mounted to the patient’s vital signs monitor for continuous remote viewing of the O2 sat reading. If O2 sat drops below a patient-specific critical value, the interface alerts the technician to troubleshoot by redirecting the patient or involving the clinical staff.

In addition to the Tele-Monitoring technician, the ability for remote viewing has been expanded to include a multi-view monitor at the central nursing station and a tablet with two-way audio and camera controls. This enables the clinical team to monitor their patients and their vitals without needing to use PPE or increase their exposure to the virus. This rapid implementation has provided urgently needed covid-patient safety monitoring with video, audio and O2 sat monitoring, increased staff safety and ability to scale efforts to care for more patients as well as providing comfort and more human connection for this isolated patient population.