Enhanced pulse oximetry tele-monitoring: connecting a personalized care

Abstract Description

Proposed Topic (Most preferred): :

Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)

Authors (including presenting author) :

Mo KC(1), Ng MW(1), Tsang HC(1), To YL(1), Choo KL(2)

Affiliation :

(1)Physiotherapy Department, North District Hospital, (2) Department of Medicine, North District Hospital

Introduction :

With continuous pulse oximetry tele-monitoring, respiratory team could closely monitor oxygen users after discharge. Traditionally, post-hospital discharge physiotherapist's(PT) home visits and equipment set-up by vendors were required for new users or those who required flow adjustment. PT would then interpret vendor-generated reports to decide whether further consultation and follow-up visits were required. In this traditional caring model, multiple emails and phone calls were required for service liaison among patients, healthcare providers and vendors. Time spent in logistic and communication with third parties may delay the whole caring process.

In late 2022, a new model of wearable tele-monitoring sensor was introduced and allowed near-real time data retrieval. Hospital-owned asset and easy set-up saves time spent in logistics. PT can now access patient’s health data through a secured cloud platform for live data. This enhanced caring model allows early result interpretations by PT for efficient clinical decision-making and optimal for personalized care.

Objectives :

To compare the clinical efficiency and effectiveness of tele-monitoring services between smart technologies-enabled model and traditional model by vendor.

Methodology :

With a retrospective case-historical control design, clinical data of patients who received tele-monitoring services from November 2022 to August 2023 (enhanced model) and November 2021 to August 2022 (traditional model) was reviewed and compared.

Result & Outcome :

There were 26 patients being monitored by the enhanced model and 20 patients by the vendor service. Apart from younger patients' age in the enhanced model, the disease mix and severity were similar.

Since the set-up was installed by PT immediately, waiting time was eliminated compared with 2.8±2.8 waiting days in the traditional model(p<0.001). Time spent waiting for report was reduced by more than 60% (from 7.6±3.8 days to 2.6±2.1days, p<0.001). Because of the improved clinical efficiency, the monitoring period was reduced by 74% (from 10±8.4days to 2.6±1.3days, p<0.001). Mean monitoring hours also decreased from 100 to 50 hours. Fewer PT on-site home visits were needed (reduced by 57% from 5.4±4.4 times in traditional model to 2.3±1.6 times in enhanced model, p=0.002)

There is a trend towards improved clinical effectiveness with more successful oxygen titration achieved in enhanced model (53.8%) than traditional model (40%). The 28-day hospital re-admission rate was similar in both models (7.7% in enhanced model compared with 5% in traditional model, p=0.714).

Enhanced tele-monitoring model improves clinical efficiency without jeopardizing clinical effectiveness. Equipment with simple settings saved time on logistics. Cloud platform for data transfer reduced time spent in communication and improved traceability.