Surveillance Monitoring: Current Challenges and Solutions
Because these systems are software applications, there is no issue of patient acceptance. Likewise, after initial installation and implementation, deployment of the application across a patient population is simple.
The data that drives clinical decision support systems varies. Some solutions take real-time data from continuous patient monitors and become an additional component in an overall surveillance monitoring solution. Other approaches use data from the EMR, such as recorded vital signs, lab test results, and clinical assessments. Software solutions that overlay existing vital signs and clinical documentation procedures preclude the need for physical patient monitors, but require data to be collected and charted in an accurate and timely manner.
Examples of clinical decision support solutions for surveillance monitoring include OBS Medical (http://www.obsmedical.com) and PeraHealth (http://www.perahealth.com). Lyntek Medical Technologies (http://lyntekmedical.com) is an example of an innovative visualization technology for detecting deterioration.
Whole-product solution
In addition to basic surveillance monitoring technology, many other capabilities go into a complete surveillance monitoring solution. Current solutions vary considerably in terms of how complete they are, so it is important to assess the full breadth of the solution required.
These systems should be able to send appropriate monitored vital signs data to the patient’s chart in the EMR. Event review and data analysis provide a review of collected data for diagnostic purposes. Remote surveillance—via PCs and mobile devices—is another common and valuable feature of patient monitoring systems. In addition, alarm notification is a key component in a surveillance monitoring solution. Regardless of the type of technology used, caregivers and rapid response teams need timely and reliable notification when patients exhibit signs of deterioration.
Many of the components of a whole-product solution may be available from a surveillance monitoring solution provider. Commonly, companies that supply these systems may partner with other companies to deliver a whole-product solution. And sometimes, hospitals will already have components of the overall solution; rather than duplicate components, like alarm notification, the goal is to have everything working together regardless of manufacturer.
Summary
Surveillance monitoring systems are intended to improve the afferent limb of rapid response systems. These systems can better recognize clinical deterioration and signal the need for rapid clinical interventions to rescue patients. There are three approaches to surveillance monitoring: patient-worn monitors, remote sensing monitors, and specialized clinical decision support systems. Effective surveillance monitoring examples come from each approach. Adopting an effective technology solution requires an organization to understand its own needs, perform a detailed assessment of solutions, and consider a whole-product solution that extends beyond the surveillance monitor itself.
Tim Gee is principal and founder of Medical Connectivity Consulting (www.medicalconnectivity.com) where his practice revolves around workflow automation through the integration of medical devices with information systems and enabling technologies. Gee is the 2012 recipient of the American College of Clinical Engineering’s Challenge Award. Gee writes for the Medical Connectivity blog, serves on the editorial advisory boards of a number of publications including Patient Safety & Quality Healthcare, and participates in key industry interoperability development efforts. He may be contacted at tim@medicalconnectivity.com.