This article appears in the July/August issue of HealthLeaders magazine.
Thanks to mobile technology, the line between acute and nonacute care is blurring, reaping benefits for providers and patients.
Using technology ranging from newly miniaturized vital signs monitors to FDA-approved portable devices for measuring asthma symptoms, providers are seeing improved outcomes today—and great potential as the mobile monitoring trend just starts up its adoption curve.
Away from the ICUs, on the regular nursing floors, patients in postacute care can benefit from portable monitors such as Sotera Wireless' ViSi Mobile, according to Lisa Graydon, chief nursing officer of five Salt Lake City–area hospitals of Intermountain Healthcare: Intermountain Medical Center, LDS Hospital, the Orthopedic Specialty Hospital, Riverton Hospital, and Alta View Hospital.
ViSi Mobile, which straps to a patient's wrist, monitors and displays ECG, heart-pulse rate, respiratory rate, blood pressure, blood oxygenation level, and skin temperature. "Those patients are much more mobile," Graydon says. "We expect them walking in the halls. If we can monitor them, their vital signs, more closely, wirelessly, or in some way not invasive to them, then we could probably provide a safer environment, and we're all about patient safety at Intermountain."
To evaluate ViSi Mobile, Graydon and nurse administrators from two of the five hospitals—the 460-bed Intermountain Medical Center and the 200-bed LDS Hospital—selected a floor in each facility with patients recovering from orthopedic surgery. To formalize its study of the device, Intermountain went through its institutional review board, Graydon says.
Out of that came a three-phase trial approach. In phase one, Intermountain nurses and patients simply wore the ViSi Mobile device during rounds. "The patients got to wear it just for a little while to see how comfortable this is," Graydon says. "We didn't monitor anything. We didn't use the data. We just wanted to see if it was comfortable, and then we took a survey to see how people felt about it."
Then, in April 2013, Intermountain began getting patients' consent to begin having them wear the devices. About 20 patients in each facility agreed to be monitored, Graydon says. At first, the number of alarms being generated by the ViSi Mobile devices due to sensitivity to vital sign changes was a nuisance. Sotera Wireless took the initial data collected, deidentified it, and ran it through a software simulator to troubleshoot the device's software to reduce the number of nuisance alarms.