Country Selector: United Kingdom
Phil Stuart-Douek is a clinical consultant for healthcare communications experts Ascom. He has more than 30 years’ experience as a registered nurse working within Emergency departments, intensive care, neurosurgical and vascular surgical wards. For the past 12 years Phil has used his experience working on the frontline of healthcare, including volunteering as a community first responder for the Welsh Ambulance Services NHS Trust, as a clinical consultant for health technology businesses.
In this article, Phil answers questions about how patient monitoring has evolved over the past three decades and what the future might hold around monitoring innovation.
What has changed for the better?
The technology that’s now available for monitoring patients – both within a clinical environment and outside of it – is transforming how care is delivered and improving outcomes for patients.
Without question, the technology and the data insight it can provide is one of the most significant and positive changes to happen to healthcare in the last two decades.
It’s an evolution I’ve seen through my 30 years as a registered nurse and a brilliant example of how far patient monitoring technology has developed within the evolution of the nurse call system. It’s no longer just a button for the patient to get the attention of a nurse. Instead, it now works much harder. It’s smart, with the ability to interact with other medical devices and software. It provides the nurse with a vital tool to help closely monitor a patient and can support workflow management.
The technology can interact with all the medical devices connected to the patient – such as a ventilator or IV drip. If, for example, a patient’s blood pressure suddenly spikes, an alarm can be raised to alert the medical team via a handheld device, or through a smartphone iOS or Android App. Effectively, the technology is providing nurses with extra ‘eyes and ears’ on their patients – something acutely needed as many hospitals move away from Nightingale-style wards.
At the bedside a nurse can update the patient’s record from a handheld device in near real time. It means nurse administration time can be reduced significantly. There are no lost forms, no requirement for deciphering someone’s handwriting and no delay in clinical information being shared. There is also the bonus of being able to potentially save the NHS significant costs in removing the need for paper-based records to be archived.
Prompts to remind nurses of routine tasks can also be automated. The clinician can create an alert for tasks such as dispensing medication or when a patient needs to be turned to prevent pressure sores while at the patient’s side. This takes the burden away from nurses and ensures patient care is mapped.
Accelerated by the pandemic, remote patient monitoring technology is changing not only how care can be delivered but where. It’s an exciting technological development, providing the opportunity to not only free up capacity within hospitals but more importantly enabling the possibility for much earlier intervention.
As a volunteer community first responder with the Welsh Ambulance Service I’ve seen first-hand the impact remote monitoring can have. Previously if a patient wasn’t in crisis, but there was the smallest chance that could change, they would be admitted into hospital to be monitored closely. Now, with remote technology, the patient can stay comfortable at home and be tracked by healthcare professionals who can intervene if their condition worsens.
For chronic conditions there is an escalation before a crisis, but without remote technology, often it will result in a visit and potential hospital admission. Now, earlier preventative care can be delivered before that stage – keeping patients stable for longer.
What has changed for the worse?
I think health technology is a critical part of the NHS’ present and its future, but it can’t be used to plug resourcing gaps.
Just last month (September) the Royal Colleague of Nursing Scotland reported that their student nurse intake was short by 700 nurses to meet the government’s target. In fact, there isn’t currently a part of the NHS that isn’t overstretched and under-resourced.
While technology is providing lots of innovation, particularly within patient monitoring, it will never replace highly trained nurses.
Returning to the example of the nurse call system, one of the reasons for its evolution beyond it being a simple intercom between patients and nurses was to help remove some of the barriers that were stopping nurses from spending quality time with those under their care. One of which being removing paperwork and in turn providing point of care access. The technology has been designed to help nurses maximise their time and allow them to focus on delivery of care.
But, if nurse levels are depleted, and the time being freed up is not used on direct patient care, there is a danger that technology such as this will start to prop up a system rather than enhance it.
To be able to move forward in achieving the NHS’ aim of a single source of truth we, solution providers, technology manufacturers, developers, and innovators, need to operate with open systems and work more collaboratively.
What still needs to change?
We’re still a way from achieving the much-needed single source of truth from the data collected through medical devices and health technologies.
The data the NHS now has is an incredibly powerful asset but accessing it in any meaningful way across all areas of the NHS is still problematic. Data still sits in silos.
That’s data which could, through responsible and secure means, be life-changing and in many cases lifesaving, if it could be accessed across the whole of the health ecosystem.
What needs to be put in place to deliver this necessary change?
To be able to move forward in achieving the NHS’ aim of a single source of truth we, solution providers, technology manufacturers, developers, and innovators, need to operate with open systems and work more collaboratively.
Medical devices need to communicate with one another regardless of who the manufacturers are. The technology is now there to enable interoperability and there is appetite for greater collaboration to achieve these goals between health boards and health-tech organisations.
Promisingly, we’re seeing examples of how data can be harnessed to create pockets of insight within the NHS, such as the Intensive Care National Audit & Research Centre (ICNARC) and the national Critical Care Information System for Wales that Ascom is involved in. Although these examples represent a small part of the journey towards achieving NHS-wide interoperability, they signify large leaps forward in how we can deliver a single source of truth.
The future: where we are heading next/predictions for the future/your hopes and aspirations?
There is huge potential still for the future of patient monitoring technology, with almost certainly more innovation to come in developing areas such as remote health monitoring as virtual hospitals grow at pace. For years those working in the NHS have tried to find solutions that could ease the rate of hospital admissions and to free up hospital bed capacity. While remote technology isn’t a cure all for these problems, it does have the capacity to make a difference through earlier intervention that could be treated within the community, through primary care and virtual care environments.
Cableless patient monitoring will play a vital role in the future of care. What was the stuff of science fiction 20 years ago, such as the tricorder in Star Trek, a device that examines patient vital signs in an instant is growing closer to becoming reality.
Without question, data is the future of healthcare. With a single source of truth – which I do think is within the NHS’ grasp – we’ll be able to improve the lives and health of many patients and learn much more about conditions and their treatment through population health trends.
The impact of research to population health was highlighted during the pandemic, with insight shared not only through the NHS and across the UK, but on a worldwide scale. That for me is the future of healthcare.
In my career in the industry, I’ve seen so much change with regards to IT integration within the health service. I’m excited to see what the next 20 years have in store for us.
This article has been published in the Clinical Service Journal (November 2022 edition). Click here to view.