Research: Continuous Surveillance of Sleep Apnea Patients in a Medical-Surgical Unit.

This report consists of two separate studies on the use of continuous capnography monitoring conducted in an effort to improve patient safety at Virtua Health System. The desire for improved patient safety is motivating continuous monitoring and improved surveillance in clinical areas not traditionally equipped for such monitoring. We explored the use of remote monitoring of capnography, using enterprise middleware, in patients recovering from surgery in a medical-surgical unit. Continuous monitoring traditionally has been used in higher-acuity settings, such as intensive care units. Patients diagnosed or suspected to have obstructive or central sleep apnea may benefit from the increased surveillance afforded by continuous monitoring. Pain management in this cohort of patients, recovering from bariatric, joint replacement, or other major surgery, often involves administration of opioids (e.g., hydromorphone, morphine sulfate), which are known to increase risk of respiratory depression. Continuous monitoring of these patients increases the likelihood of detecting adverse clinical events. Our goal was to implement continuous monitoring in order to identify alarm conditions caused by adverse clinical events requiring intervention (e.g., opioid-induced respiratory depression) and artifacts related to patient movement, suspect measurements, or other medical device-generated alarm signals.

Facilitating Virtual Health Management Using Medical Device Integration.

Data from connected medical devices (CMDS) provides an objective and rich source of information to augment patient care management and clinical decision making. A principal reason is measurements of patient properties made through bedside CMDs are not typically subject to errors associated with misinterpretation, incorrect recording, and incorrect time stamping. Furthermore, data from CMDs can be collected regularly, ensuring a dense and robust data record on a given patient. The ability to remotely manage and monitor patients is greatly facilitated by access to data, as measurements represent an objective source of information that facilitate clinical decision making. In my recent book, Connected Medical Devices: Integrating Patient Care Data in Healthcare System, I discuss the topic of medical device integration (MDI) in relation to implementing CMDs in healthcare settings as a guide to assist hospitals in this undertaking. The following discussion about MDI are the opening paragraphs from this text, followed by a discussion of MDI architectures.