How Contactless Vital Sign Monitoring Transforms Remote Patient Care

Let's be honest. Wearing or applying any device to patients every few hours leads to irritation, noncompliance, and fatigue. Contact solutions are effective in the hospital, but once patients return home or enter long-term care, the value diminishes. Remote patient monitoring programs attempted to solve this problem years ago, and many solutions today still involve some kind of self-administered sensor. Contactless vital sign monitoring systems take data collection beyond what's possible with traditional contact sensors

How do contactless vital sign monitoring systems work?

The short answer? These wireless monitoring devices use different combinations of the electromagnetic spectrum and algorithms to collect quantitative physiological data remotely. Radar sensors create and receive RF (radio frequency) waves that reflect off the surface of the body and indicate heart activity and respiration. Some camera-based variations take advantage of photoplethysmography, or changes in skin color, to achieve a similar effect. All of these variations eliminate the need for physical contact sensors, heart rate and breathing can be acquired through a blanket or sheets without touching the patient. In skilled nursing, the contactless vital sign monitoring and other long-term care facilities have a sensor mounted in a nightstand or on the wall, where patients typically cannot see it. Bed-ridden patients receive uninterrupted, undisturbed sleep or rest while data is collected continuously.

Why is this especially valuable to chronically ill and aging patients?

Patients with chronic conditions require constant oversight. When their respiratory rates increase, they typically require more immediate response than if these changes only occurred during regular vital sign measurements. Remote patient monitoring programs collect continuous vital sign data through contactless monitoring solutions and analyze trends or irregularities using cloud-based EHR systems . One peer-reviewed study that tested radar sensors combined with predictive analytics software correctly identified most patients who were going to be admitted for cardiac or respiratory concerns within 6 days. This intelligence gives facility staff the time to adjust medications or talk to the patient's physician without putting the patient through a traumatic emergency.

Does it compromise patient privacy?

Not necessarily. Cameras do have privacy implications most would find unacceptable inside a skilled nursing facility. Radar technology does not "see" the person on the other side of the bed, but it can penetrate surfaces like blankets, walls, and furniture. Radar monitoring systems only display quantitative data like heart rate beyond the bedside. The ability to prevent unnecessary or inappropriate disclosure of personal information and health records makes these solutions better than many wearable devices.

Doesn't that take away vital support staff?

Nursing staff already has a tremendous burden. Manual readings consume hours upon hours of their day. Remote patient monitoring software automates data collection, entering metrics directly into the EHR. These solutions use analytics to interpret the data, reducing the number of false alarms before nurses even review the information. Some operators report reduced alarm fatigue and significantly fewer visits to patients with a consistent but reduced false-positive rate after introducing radar-based remote patient monitoring programs. Time spent reviewing data can be redirected toward actual patient care, especially in understaffed facilities.

It has limitations, compared to a standard contact method.

Motion has a major impact on optical sensors, particularly in camera-based contactless vitals monitoring solutions. Radar monitoring systems are much more efficient at handling the noise and interference of movement. Motion is still an issue, but software filters out some motion to separate actual physiological activity. Accuracy is appropriate for the application, but operators should have acceptable expectations when comparing continuous remote monitoring to single-point measurements at regular intervals. The remote patient monitoring programs use continuous data over time to determine variations and abnormalities of a given patient relative to their baseline values.

Contactless vital sign monitoring is only valuable when it feeds into remote patient monitoring software.

After all, a collection of numbers without interpretation only represents information that can be ignored, exaggerated, or used for inappropriate purposes. The analytics tools give this stream of data context by evaluating general trends in patient health and identifying potential risks. TapestryHealth already utilizes wireless remote patient monitoring programs through their own remote patient monitoring software in skilled nursing and similar care settings. The data from radar sensors is then compared to pre-programmed standards to determine whether the patient's condition requires any intervention. If these programs did not exist, the contactless vital sign monitoring devices would only be another piece of hardware providing marginally more valuable data than a regular temperature reading every other day.

Can skilled nursing facilities afford this?

The cost versus the benefits should be evaluated at the facility level. Hardware only accounts for a small piece of the overall economic puzzle. Remote patient monitoring programs in skilled nursing facilities will eventually bill for the service according to standard practice, rather than per-diem or per-visit charges as with traditional remote patient monitoring services. In addition to financial benefits associated with reduced in-facility or in-hospital transfers, reduced staff time spent collecting and interpreting data translates directly to lower labor costs. Early results suggest reduced transfers with continuous data support and significantly reduced in-facility transfers when using a remote patient monitoring program compared to facilities not yet using continuous remote patient monitoring.

Is there any downside?

At the moment, yes. Radar technology is sensitive to major changes in the body, such as large-scale movements. When combined with an algorithm, it produces a surprising amount of meaningful data, but its value is hampered without additional information. In addition, multi-person occupancy in the monitored room can confuse lower-level solutions currently on the market. Blood pressure and temperature still require a separate sensor outside of the bed. Poor lighting affects photoplethysmography solutions and may make reading these values problematic. Finally, a functional WIFI or cellular connection is required for these devices to transmit data directly to the remote patient monitoring programs. Operators considering adopting contactless remote patient monitoring technologies therefore do not have the option of ignoring current limitations. Most importantly, they should implement solutions in combination with traditional remote patient monitoring programs and regularly scheduled vitals checks to account for the limitations of each technology. The benefits clearly outweigh the costs for operators who can afford the equipment. The early studies cited above show that the facilities implement this technology significantly reduces inpatient and in-facility transfers and allows for faster, more targeted interventions. Most importantly, patients who might not otherwise qualify for remote patient monitoring services can benefit significantly.

What will happen when these technologies become common?

This technology is on the verge of a breakthrough. Healthcare facilities across care types understand the need to reduce in-facility transfers by reducing unnecessary interactions with staff and increasing the accuracy and speed of interventions. Contactless vitals monitoring solutions with remote patient monitoring programs represent one of the most promising ways to accomplish these goals. Radar-based variations can be found in many skilled-nursing facilities across the country, tracking the vitals of millions of patients who sleep through the process. Camera-based solutions are expanding rapidly, providing similar data during telehealth visits and consumer health applications. More specific data from each patient will continue to be gathered in the future, including further filtering of physiological signals, handling of multi-person occupancy, and additional vital signs. Facilities attempting to implement these programs will have an easier time adopting them in 5 years than they do today. That is, if they survive the wave of new patients coming through their doors when the next round of higher acuity patients arrives.

Visit TapestryHealth to learn how to take advantage of this technology for your specific applications and reduce unnecessary in-facility or in-hospital transfers due to unmonitored vital sign changes during stays.

FAQ

What is contactless vital sign monitoring?

Contactless vital sign monitoring refers to a general category of devices and methods that measure physiological quantities without making physical contact with the body, through either direct mechanical connection or material transfer

How does contactless monitoring augment current remote patient monitoring programs?

By eliminating the need for patients to manually activate any device or for nurses to visit multiple times per day to manually obtain values, remote patient monitoring programs using radar or camera technology can collect continuous data, identify trends earlier, and intervene more successfully.

Is radar an accurate enough technology for clinical decision-making?

Radar technology has proven to be somewhat accurate in studies comparing values against more traditional forms of contact monitoring within the context of a single patient's baseline value. Combining it with standard remote patient monitoring programs can help provide appropriate analysis on an individual patient's condition.

Does this solution address patient privacy concerns?

Radar monitoring software typically does not collect or display any biometric data beyond numerical values, unlike camera-based solutions. As such, it typically operates under greater privacy protection than many wearable or otherwise non-contact vital sign monitoring technologies currently in use.

Can these solutions be reimbursed when used for remote patient monitoring purposes?

Any remote patient monitoring program will have to meet certain requirements before being eligible for reimbursement. Solutions provided by TapestryHealth, Inc. or similar companies should meet these requirements when applied per the instructions for use to identify patients appropriate for transfer or those requiring closer in-facility monitoring.