Leading Edge Patient Monitoring: Now Piggybacks on Facility Wi-Fi

Sponsored by an educational grant from Dräger
Patient monitoring is key to excellent patient care. Southeast Alabama Medical Center (SAMC), a 420-bed facility in Dothan, Ala., is an innovator in this space, standing at the forefront of progressive cardiac patient monitoring. The difference comes in stepping away from telemetry and into truly wireless patient monitoring. The enabler is the Dräger Infinity M300 patient monitoring system that brings wireless telemetry to a new level: Increasing mobility for patients and accessibility for caregivers, while decreasing complexity for the facility IT department.

SAMC first installed wireless networking technology in the 1990s and has been improving on it year after year to stay up to industry standards. Last year, as SAMC prepared to expand its telemetry services in its inpatient unit, an upgrade to its mobile devices in efficiency and volume was needed, says CIO Eric Daffron. One solution stood out among the rest: The Infinity M300 is the only monitoring system that utilizes a hospital’s established Wi-Fi network, bypassing the need for the device’s own proprietary network. That saves time, money and manpower.

“The way telemetry was done in the past, you needed a proprietary network for any mobile device that you would use. If you wanted to expand the network, you had to increase the number of antennas in the facility,” says Daffron. “Now we have 100 percent coverage with any possible expansion and there’s no additional cost infrastructure-wise.” This means patients, as they increase their mobility as they recover from surgery or an illness, can travel freely throughout the facility, with caregivers having constant access to vital data and the ability to instantly track them if a problem arises.

How it works

Pulling from a 50-mile radius within Alabama and serving a cachement area of 600,000 people throughout southeast Alabama, southwest Georgia and the Florida Panhandle, SAMC averages 320 patients daily within its tertiary care center. About 150 of those beds are filled daily with cardiac patients who are monitored using the M300 from what is dubbed the “war room” on the 4E Unit, says Bobbye Corbin, director of the unit.

Here’s how it works.

The wireless patient monitor, about the size of a large cell phone and weighing about 0.6 pounds, is worn in a lightweight pouch around a patient’s neck. Its color display shows ECG for all monitored leads, heart rate, oxygen saturation and electrode status as well as demographics to confirm patient identification. Built-in sound capabilities allow SAMC caregivers to hear alerts at the patient’s side, and handle them by pushing a button on the device, as well as at the Infinity CentralStation. Built-in ACE (Arrhythmia Classification Expert) and pacer detection algorithms enhance ECG processing, while helping to reduce false alarms. A ‘find device’ function helps caregivers locate lost devices or patients in distress within the hospital.

Each device, which runs on IEEE 802.11 b/g industry standard wireless technology, provides continuous patient monitoring—even if the patient inadvertently moves out of the hospital’s wireless network coverage area. It is assigned an individual IP address, much like a laptop when logging onto a Wi-Fi network. Two-way communication between the wireless monitor and the central monitoring station facilitates wireless data exchange and signal integrity within the hospital’s wireless network coverage area. The CentralStation gathers and displays information from Infinity bedside and patient-worn monitors for central monitoring of up to 32 patients on the Infinity Network.

Drawing on the power of an internal Cisco IT network at SAMC, the 6-lead EKG monitors are connected to the patient and can do a 12-lead EKG when a patient is laying down as much as three floors away, Corbin says. “The system gives you a great compass point to see the clinical information you need to see.” Once cardiac patients are well enough to get up and walk around, they enjoy complete mobility throughout the facility while their heart is monitored 24/7.

“In the past, if a patient went for an x-ray, he or she was essentially not monitored because there were no antennas in the x-ray room,” explains Daffron, adding that “now patients are able to be centrally monitored and move about the 1 million square feet campus freely.” All the while, caregivers can keep a careful eye on them and even go to them if an emergency arises.

Patient monitoring central

Within the centralized monitoring center, SAMC has the capability to monitor 200 patients with individual monitors, displaying 16 patients on each screen. Four technicians continuously monitor patient's rhythm, changes in rhythm, patient alerts and any arrhythmia first hand. They immediately call on a patient's nurse if they spot a problem.

"Anyone can have an adverse event," Corbin says. "With cardiac disease, we want to be on top of identifying those events and make sure arrhythmia is taken care of immediately. Lives are saved daily whereas when you don't have monitoring of this capability, time is lost and those critical 1 to 5 minutes makes the difference between life and death."

Another boon to the rollout was dual functionality that the new system offers in monitoring both heart rate and oxygen saturation in one device rather than two. "Cost wise, there are savings simply by employing one simple transmitter," says Daffron. It also simplifies the stay for the patient not having to lug around two devices, he adds.

Logistics of keeping the monitors running is easy as well. Charging the monitor’s rechargeable battery is like charging a cell phone. Either put it in a small bedside charger or swap in a full battery and recharge it at a central multi-charger. The clinical cardiac staff likes this feature, Daffron says, compared with the once-a-shift 9V alkaline battery changes they had to do with the prior generation of technology. “The rechargeable battery has made SAMC a super saver in terms of battery costs, resulting in savings of over $35,000 a year in battery costs alone.”

Seamless integration

Transitioning from one clinical system to another is often problematic. But not this time. "Painless" is the way Daffron describes the transition to wireless patient monitoring. The project took about a month to complete, but only involved 10 human hours because technicians and clinical staff were already well-versed in wireless technology and workflow.

Noting that a health IT network is not a "set it and forget it" infrastructure, Daffron predicts a boom in patient care technologies that utilize internal Wi-Fi networks. This is "our first test of having medical devices operate over our internal Wi-Fi network and it's been a success so far. We anticipate other vendors and devices to shortly be following suit," says Daffron.

"Lines are being blurred between health IT networks and portable medical devices," he continues. "The mobile health IT game is becoming one in the same, operating on one, central network and having a lot of the same functions."

Patient monitoring is a brave new world, keeping up with the needs of more mobile patients and caregivers. Wireless mobile devices have the strength of full-size, bedside monitors with the versatility of multiple monitoring systems. The future is now.