The Future of Patient Monitoring

Nov. 23, 2009

Patient monitors have typically tethered patients to their beds with restrictive cables, presenting challenges for caregivers and patients alike.

Patient monitors have typically tethered patients to their beds with restrictive cables, presenting challenges for caregivers and patients alike. For caregivers, wired monitoring restricts the ease of patient transport between care areas, limits flexible acuity monitoring (the ability to add or remove incremental clinical measurements as the patient’s status changes), and hampers data integration between devices and systems. For patients, being tethered to a bed restricts mobility and comfort, potentially inhibiting rapid recovery, particularly in critical-care patients.

Hospitals are rapidly adopting wireless technologies that have the potential to change the way doctors, nurses and healthcare institutions operate. Hospitals, for example, are expanding their use of medical telemetry, a portable system worn by the patient that continuously measures a variety of vital signs and wirelessly transmits data to a central location.

Patient monitors have typically tethered patients to their beds with restrictive cables, presenting challenges for caregivers and patients alike. For caregivers, wired monitoring restricts the ease of patient transport between care areas, limits flexible acuity monitoring (the ability to add or remove incremental clinical measurements as the patient’s status changes), and hampers data integration between devices and systems. For patients, being tethered to a bed restricts mobility and comfort, potentially inhibiting rapid recovery, particularly in critical-care patients.

Hospitals are rapidly adopting wireless technologies that have the potential to change the way doctors, nurses and healthcare institutions operate. Hospitals, for example, are expanding their use of medical telemetry, a portable system worn by the patient that continuously measures a variety of vital signs and wirelessly transmits data to a central location.

Current telemetry systems receive patient information from wired electrodes connected to the body. Initially suited to monitor patients on a single floor or unit, today’s medical telemetry systems are extended throughout entire hospital buildings and medical campuses.

A class of technologies called wireless medical body-sensor networks (BSNs) represents a potential new approach to wireless patient monitoring. This technology could replace the traditional tangle of bedside cables used to capture a patient’s vital signs. BSNs would consist of miniaturized body-worn sensors that collect critical patient-specific information, such as temperature, pulse-oximetry, electrocardiogram readings and respiratory function. Each body-worn sensor would communicate information about the patient’s vital signs, via short-range wireless signals to a small nearby receiver.

Leveraging complementary long-range wireless technologies such as telemetry, this real-time patient information could then be transmitted from the receiver to doctors and nurses, enabling efficient monitoring of patient vital signs, no matter where the patient is located in the hospital – or even remotely from the patient’s home. The data could ultimately flow to centralized monitoring stations or automatically update electronic medical records.

In June 2009, the Federal Communications Commission issued a notice of proposed rule making to allocate radio spectrum establishing a new, vendor-neutral, dedicated radio frequency for low-power, short-range wireless patient medical devices, such as BSNs. If adopted, it will provide a protected spectrum for wireless medical BSNs and reduce the potential of interference from ubiquitous unlicensed radio devices, such as Bluetooth, Zigbee or Wi-Fi. Protected BSN bandwidth would be similar to protections currently in place for medical telemetry.

BSNs could offer many potential clinical and work flow benefits:

Ease of transport: Transporting a patient from one area of the hospital to another often requires caregivers to move the equipment along with the patient, or to disconnect and reconnect the patient to devices. With BSNs, caregivers would no longer need to disconnect and reconnect wires, allowing for enhanced data continuity and supporting efficient patient transfers.

Flexible acuity monitoring: With BSNs, caregivers will be able to quickly add or remove parameter sensors as medical conditions warrant, integrating and evaluating parameters to help them make informed treatment decisions. Additionally, BSNs will allow caregivers to wirelessly monitor many parameters outside of specialized-care areas. Neurologists, for example, could stay connected to patients whose EEGs are being measured – without having to transfer the patient to the neurology unit.

Patient mobility: By untethering patients from the bedside, they can be more mobile, which can help contribute to improved patient outcomes, faster recovery and reduced length of stay.

Data integration: Leveraging existing technologies, automatic data transfer could be possible from BSNs to electronic medical records. Additionally, a patient’s sensors could be linked together in a body-sensor network, enabling new insights from the integrated information.

Infection control: By limiting the wires, BSNs could help reduce the risk of infection and help avoid sterilization procedures.

David Freeman is general manager, parameters, for GE Healthcare, Waukesha, Wis.

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