Ventilator information is transmitted to respiratory therapy supervisors, who can direct respiratory therapists to care for ventilated patients.
Yale New Haven Health has launched an initiative to monitor ventilators remotely.
Ventilators are essential equipment for the care of coronavirus disease 2019 (COVID-19) patients who experience respiratory failure. During the COVID-2019 pandemic, ventilators have been not only in short supply but also a staffing pain point, stretching the ranks of respiratory therapists and pulmonologists.
Remote monitoring of ventilators helps support frontline staff, says Chris Gutmann, MS, health system director of clinical engineering at Yale New Haven Health.
"The ventilator surveillance helps relieve the stress of the frontline caregivers. They have backup to help support them. Now, we can get ventilated-patient information to a respiratory therapy manager or shift leader who can have conversations with the respiratory therapists on the floor, who are feeling stressed and pulled in many directions. The supervisors can help manage the patients and the equipment in various situations," he says.
The New Haven, Connecticut-based health system features five acute care hospitals in Connecticut and Rhode Island, including Yale New Haven Hospital.
How ventilator surveillance works
The key element of the new ventilator surveillance system is connecting ventilators, which previously have been standalone devices, to Yale New Haven Health's information technology network, Gutmann says.
The remote monitoring initiative features Capsule Technologies' Capsule Neuron connectivity device, which is mounted to a ventilator and has a Wi-Fi connection to the health system's IT network. The device transmits data from a patient's ventilator and physiological monitors.
"We can then take that information and bring it to the respiratory therapy management to help them support their team. Information is displayed in an overview console that spreads across four monitors. It allows respiratory therapy management to get information in real time that they can compare to the Epic information, other patient demographics, physiological information, and lab results to support the respiratory therapists and nurses on the floor," he says.
The ventilator surveillance station is in the respiratory therapy department, which is completely removed from the clinical floors, says Samantha Herold, MS, a clinical systems engineer at Yale New Haven Health.
"When there is an event that is triggered on the central surveillance station, which is monitored from 8 a.m. to 5 p.m. by a respiratory therapy supervisor, they have the opportunity to escalate those alerts and notifications to respiratory therapists on the floor through our mobile communication system. The supervisors can make sure the staff on the floor have the information to perform an action to either correct the patient condition or modify patient alarm parameters," she says.
The ventilator surveillance system is only being monitored during regular business hours because the technology is on the cutting edge of innovation, Gutmann says. "We just can't staff it 24/7 because this is new technology, so respiratory therapy has not yet changed their entire staffing model. This is going to be a paradigm shift in the same way tele-ICU has changed how critical care doctors can support outlying hospitals."
Yale New Haven Health has IT infrastructure to support the surveillance of 450 ventilators. The initial pilot was limited to 60 ventilators, and the health system plans to have the surveillance system in place for 270 ventilators by the end of the year.
The new ventilator surveillance system is an example of Yale New Haven Health's commitment to utilizing innovative technology in patient care, Gutmann says.
"We always look to be at the forefront of technology and new care models. This definitely helps put us in that position. It dovetails into our telehealth programs in general. We provide tele-ICU services to hospitals outside of our own healthcare network. We have a relationship with Epic, where we are helping to develop their tele-ICU tools called Epic Monitor," he says.
In the future, ventilator surveillance will almost certainly have applications beyond COVID-19 care, Gutmann says. "For example, we have a comprehensive heart program at Yale that uses a lot of ventilators for patients who come out of heart surgery."
Christopher Cheney is the senior clinical care editor at HealthLeaders.
During the coronavirus pandemic, frontline respiratory therapists have been inundated with ventilated patients.
The new surveillance system connects ventilators, which were previously standalone devices, to Yale New Haven Health's information technology network.
The health system launched the surveillance system with 60 ventilators and plans to have remote monitoring in place for 270 ventilators by the end of the year.