Remote heart monitoring could lead to better emergency responses
A recent study suggests that it might be better to have off-site technicians doing remote heart monitoring for patients instead of having noisy bedside heart monitors and alarms in the hospital.
Lead study author Dr. David Cantillon, a researcher at the Cleveland Clinic in Ohio, said that traditional on-site heart monitoring involves a lot of false alarms that are not helpful in detecting cardiac arrests and other serious events. He said that important warning signs are missed among a large number of nuisance alarms. This instance is known as ‘alarm fatigue’ and has been associated with serious adverse outcomes, including patient deaths across the United States.
Cantillon and his colleagues examined an alternative solution where over 99,000 patients in the Cleveland Clinic and three other nearby regional hospitals were monitored remotely. None of the patients in the study were in critical condition or receiving intensive care.
Technicians at the remote central unit monitored up to 48 patients at a time and alerted hospital staff whenever alarms suggested something might be amiss.These remote technicians provided more than 410,000 notifications over the 13-month study period, about half of which were related to heart rhythm or blood pressure issues, researchers report in JAMA.
Emergency response teams (ERTs) were activated in about 3,200 cases, including 980 instances when the heart rhythm or blood pressure changes occurred no more than an hour earlier. Most of these warnings – 79% – were accurate notifications of situations when patients needed urgent help, the study found.
In addition, the remote technicians directly notified ERTs on the worsening condition of 105 patients who needed immediate intervention. This included advance warning of 27 cardiopulmonary arrests – all but two resulting in a return of circulation.
The remote monitoring system was also associated with a reduction in the total number of patients who needed monitoring at any given time. This so-called weekly census dropped by almost 16%, when compared with the prior 13-month period.
Limitations of the study include its observational design, which makes it impossible to determine if remote monitoring directly causes specific outcomes, the authors note.