The virtual ward is on its way: how remote monitoring is changing the face of clinical care

Cambridge University Hospitals Foundation Trust (CUH) has implemented a fully integrated patient surveillance infrastructure based on Masimo’s Patient SafetyNetTM supplemental remote monitoring and clinician notification system and Halo ION™, which provides clinicians with a comprehensive, personalised and continuous patient score.

Masimo’s Root® device allow them to create a centralised patient monitoring and connectivity hub, while a variety of sensor types monitor patients’ vital signs, delivering enhanced, clear local displays to carers at the patient’s bedside, and remote monitoring capability to clinicians on mobile devices.

This degree of interoperability means the trust can extend the range of clinical input and advice into an individual patient’s care thanks to a continuous flow of contextualised and meaningful data.

Ticking all the boxes

“It’s all about flexibility, accuracy, timeliness and being more patient-centric,” says Chaudhry. “Whenever I think of all the properties of high-quality patient care, remote monitoring and the patient empowerment that comes with it absolutely ticks the boxes across the board.

“From a clinician’s perspective, a more regular flow of continuous data rather than intermittent spotting at traditional touchpoints gives you a more accurate understanding of what is ‘normal’ for that patient. So, you are better placed to use decision support tools and early warning algorithms to detect at an earlier stage and in a more personalised way when a patient’s condition is deteriorating – or even when it’s improving, and you can withdraw some treatment.”

Prof Chaudhry says the data-capturing monitoring devices enable more meaningful and appropriate use of hospital resources to support those patients who need it in a more flexible manner than in the past, when care pathways were more rigid and tended to be based around calendar appointments.

For the patient, continuous monitoring combined with remote review means they can get to a position where they get on with their life while being supported by the hospital in managing their illness.

Certainly, the challenges of medical device integration (MDI) remain. But Chaudhry says the focus on interoperability by technologies like Masimo’s means there is a straightforward methodology that enables data to be brought seamlessly into the medical record, even acting as a bridge to older devices that historically have not been so straightforward to connect.

Enter the virtual ward

Remote monitoring also brings the opportunities of the virtual ward a step closer, with obvious benefits in terms of improved efficiency and the allocation of hospital resources to those patients who need it. Chaudhry says that with proper governance, the virtual ward can be an ideal halfway house between being in hospital and being discharged.

“For example, if you can do a virtual ward related to children, their parents might have the opportunity to continue to work while the healthcare community provides support that allows the child to go to school wearing an unobtrusive monitor,” he says.

“The notion of a virtual ward, being able to send a patient home a bit earlier but with the tools and devices for the hospital to be sure of their safety, is becoming a reality. Patients often do better at home. They sleep, eat and rest better. And that frees hospital capacity while safeguarding the patient through that transition.

“I’m convinced that in the near future, people will come up with novel ways of using the data and approaches enabled by remote monitoring that will allow people to control their conditions rather than having those illnesses control them – and for clinicians to provide patients with an uplifted level of support that they wouldn’t otherwise be able to do.”