Hospital outfits are getting a high tech accessory upgrade. Gowns and socks: meet medical wearable watch.
“We call it surveillance,” said Robyn King, a clinical informatics nurse at UCHealth. “This way, nurses can notice (vital signs) changes earlier and help them look for trends over time, which is really hard to capture in a linear medical record. If a patient is getting in trouble, we want to catch them as early as possible and intervene.”
Building on the successful pilot project that began at Longs Peak Hospital in Longmont and at UCHealth’s Anschutz Medical Campus in Denver in 2017, patients on PVH’s medical-oncology and neurology floors and MCR’s medical unit will be the first group in the UCHealth’s northern region to utilize the device.
“We’ve already seen the benefits at Longs Peak and Anschutz,’’ said King, who serves as a lead liaison between the clinical and IT teams. “When we noticed a patient’s respiratory rate and oxygen level dropping, we were able to intervene quickly.”
Traditionally, nursing staff manually takes vital signs (heart and respiratory rates, oxygen saturation, temperature and blood pressure) at regular intervals. But the ViSi watch, made by Soterra Wireless and about two and a half times the size of an Apple watch, connects to patches on the chest and shoulder, allowing the device to continuously transmit data in one-minute intervals. The values are displayed both on the watch itself and remotely on a monitor.
Research shows that the vast majority of patients who have cardiac arrests show signs of deterioration in the eight hours preceding the event, according to Sarah McIntosh, project manager for its implementation across UCHealth’s northern region. And with three quarters of adverse medical events and preventable deaths occurring outside of the intensive care unit, the ViSi system is the perfect antidote.
“Now staff can see that a patient’s blood pressure, for example, though it’s still within normal limits, over the last four hours it has dropped,” McIntosh said. “What does that mean? Probably nothing alone. When you combine that with increased heart rate or respiratory rate, what are we talking about that could be going on? The nurse is much more involved in thinking critically.”
But this product, the first such FDA-approved device on the market, is more than simply a healthcare device. Going live required complex planning on a host of issues ranging from infrastructure to clinical components to day-to-day processes, giving McIntosh all she could handle.
“I don’t think people really understood what it was going to take to implement this. We didn’t even know,” McIntosh said. “It has to integrate with EPIC and the phone system, and communicate over our wireless network, so it requires coordination with lots of teams.”
In addition to months of preparation that involved focus groups, data analysis and integration with the electronic medical record, McIntosh and King continue to work with clinicians and IT teams to ensure a smooth transition. For instance, clinicians from northern Colorado visited the UCHealth Anschutz Medical Campus last summer to get firsthand experience on the front end. And super users from UCHealth Memorial Hospital in Colorado Springs were present during northern Colorado’s go-lives.
“This way, we create a network of super users that is helpful for training new staff, and also for trouble shooting,” King said. “With every electronic device – think of your phone – every once in a while there’s something you need to tweak. Super users will have more knowledge about those devices than other people working on the units.”
This includes having trained super users on every floor 24/7 for two weeks after going live to help nurses and aides feel comfortable with novel workflows, and things like dealing with alarms that sound on their phones when a patient’s vital signs go outside of set parameters.
“The initial thought was that this would reduce workload so it might save time,” said McIntosh, who pointed out that nurse’s aides typically spend at least 10 percent of their shifts taking vitals, and that research has also shown a potential time saving for nurses of up to 12 hours in a day. “But it actually allows the CNAs to refocus their work on the mechanics of patients, like getting them up and walking them, helping them to the bathroom or a shower.”
Like all new technologies, this will require a learning curve, according to Dr. Christine Johnston, senior director of Informatics for UCHealth who remains involved in the device’s implementation at Longs Peak and evaluating the data. She is excited for UCHealth to be on the forefront of medical informatics and see how the wearables improve patient care, patient safety and patient satisfaction.
“This is truly cutting edge technology,” Johnston said. “Taking vitals will be less intrusive. The risk of passing infection from patient to patient should decrease. Data will be available real time on our patient’s clinical status. The ability to monitor trends and identify both deteriorating and stable patients will help clinicians make better decisions for our patients.”