Oxevision is a patient monitoring tool that supports staff to improve safety and to provide individualised, person-centred care to patients in inpatient mental health services.
It cannot and should not replace therapeutic engagement with patients or the visible presence of staff in these settings.
Oxevision includes a regulated medical device that uses an infrared-sensitive camera. It enables staff to visually confirm a patient is safe (with a maximum 15-second clear view into the room) and to measure their vital signs (pulse rate and breathing rate) without disturbing their sleep.
Staff also receive real-time, location-based alerts to potentially high-risk activity (for example, if a patient gets out of bed, leaves the room or spends a prolonged period of time in their ensuite bathroom), enabling staff to consider whether they should intervene quickly to reduce the risk of harm to patients.
Staff can use the system to generate reports on a patient's pulse and breathing rate trends and location-based activity in their room. This information supports clinical decision making and can be used with patients to plan more individualised, person-centred care.
For further information, click here.
Oxevision uses an infrared-sensitive camera, housed in a secure unit installed in a patient’s room, to measure pulse rate, breathing rate and movement.
- Pulse rate: when someone’s heart beats, their skin flushes red momentarily. Oxevision’s infrared-sensitive camera can detect these ‘micro blushes’ which are invisible to the human eye. The system counts the micro blushes to measure a patient’s pulse rate, in the same way a pulse oximeter finger clip does. It works for all skin tones.
- Breathing rate: when someone breathes, their chest and diaphragm move and expand. Oxevision counts these movements to measure a patient’s breathing rate. It works even if they have a duvet covering them.
- Movement: Oxevision can detect where a patient is in their room. It knows where key locations are like the doorway, the bed and the ensuite bathroom and alerts to potentially high-risk activity (for example, if a patient gets out of bed, leaves the room or spends a prolonged period of time in their ensuite bathroom). Oxevision doesn’t monitor the ensuite bathroom, it just knows when a person enters that area and when they return to the main bedroom area.
Providers that have implemented Oxevision have reported and published data on a number of clinical benefits, including improved physical health monitoring and reductions in self-harm, assaults, rapid tranquillisation, falls and transfers to A&E. To read the results of published studies, click here.
In inpatient mental health settings, staff carry out in-person checks (known as observations) day and night, as frequently as every 15 minutes, to ensure patient safety. As part of these observations, staff must confirm that they saw the patient breathing and that the patient appears safe and well to them. When patients are in their rooms, staff must either open an observation window or the room’s door to look inside and visually confirm the patient is safe and well. At night, they may also need to turn the light on or shine a torch on the patient to assure themselves of this.
Clinical leaders in the UK regard these observation practices as a necessary compromise between respecting patients’ privacy and autonomy and keeping patients safe. Where possible, patients are involved in decisions about the necessity and frequency of observations.
With Oxevision, staff can complete accurate and reliable observations – which include pulse and breathing rate measurements – of patients who are resting or sleeping in their bedrooms without opening the door, entering the room, using torches or switching on lights. This reduces disturbance to patients, especially at night, and patients have reported that it gives them a better sense of privacy. To learn more, read our patient experience report.
The National Mental Health and Learning Disability Nurse Directors Forum has developed national guidance, in collaboration with patient and carer representatives, to support the safe, ethical and effective use of Oxevision on mental health inpatient wards. This is available here.
In addition, each provider develops its own protocols detailing how the system will be integrated into clinical practice and when it is appropriate to use Oxevision as part of patient care.
Oxehealth has built various controls into the technology to protect patient privacy and dignity when Oxevision is used:
- Oxevision does not monitor the ensuite bathroom in patient bedrooms, it just knows when a person enters that area and when they return to the main bedroom area
- Staff can only access a clear view of the patient’s room (which is required in standard clinical observation and engagement protocols) for up to 15 seconds when measuring their pulse and breathing rate / performing a visual safety check
- Video images available during an alert are fully and irreversibly blurred
- The device has no microphone which means no sound is recorded.
Providers can choose to retain clear video images for 24 hours for the purpose of investigating serious patient safety incidents. If clear video images are retained, they are encrypted, stored securely on the provider’s site and automatically deleted after 24 hours. These video images can only be accessed by (senior, named) clinical staff if requested to support the investigation of a serious patient safety incident in line with the provider’s local protocols.
All video data captured by Oxevision is owned and controlled by the provider.
Oxevision only covers the bedroom area. It does not monitor the ensuite bathroom in patient bedrooms, it just knows when a person enters that area and when they return to the main bedroom area. It does not cover any communal areas.
Yes, patients and their carers should be informed about the use of Oxevision, including the use of video data.
There is national guidance on this topic, developed by the National Mental Health and Learning Disability Nurse Directors Forum in collaboration with patient and carer representatives. The guidance recommends that patients and their carers are informed about the use of Oxevision on admission to a ward and there should be regular opportunities for patients to be engaged by staff in conversation about their questions and concerns.
In addition to providing information leaflets and including signage on the wards, it is important that patients (and where relevant, their carers) continue to be consulted and engaged in a dialogue about Oxevision’s use, just as ward staff would for the level and frequency of nursing observations. This is particularly important when patients and their carers find information leaflets or signage unhelpful or difficult to understand.
Co-produced patient information leaflets and ward posters are available online for providers to localise. These materials can be accessed here, along with the national guidance.
Each provider decides how they use Oxevision as part of clinical practice and develops protocols detailing what to do if a patient doesn’t want staff to use Oxevision to support their care.
There is also national guidance on this topic, developed by the National Mental Health and Learning Disability Nurse Directors Forum in collaboration with patient and carer representatives. The guidance presents two approaches to consent: informed implicit consent and informed explicit consent.
For further information, see pages 15-17 of the national guidance, available here.
Yes – providers have the option to switch the system off in individual rooms.
Yes. When observations are carried out using Oxevision, they are done so in line with the patient’s care plan, which is based on their individual risk assessment and which is dynamic in response to their current needs. Oxevision therefore supports different levels of observation of patients, as set by the clinical team.
Furthermore, data from the system (pulse and breathing rate measurements and trends, activity alerts and reports) enables staff to make more informed clinical decisions – promoting individualised patient care in response to risk. A number of patient case studies have evidenced this.
Oxevision cannot and should not replace therapeutic engagement with patients or the visible presence of staff in inpatient mental health settings.
When the system is used, staff continue to carry out in-person observations of – and to engage therapeutically with – patients who are awake or potentially in need of help in their rooms, and those who are outside of their rooms.
A patient with experience of Oxevision commented, “Staff interact with us a bit more, we only see them less at night. I think they've always been very busy, but you can see that they have more time for us with Oxevision. We still get a good amount of interaction with them.”
Similarly, a Ward Manager stated, “Before Oxevision it was constantly busy and felt like we were firefighting. Now, occasionally we’ll have some spikes but it’s better. Now you can take time to have meaningful interactions with patients and not just be reactive to an incident.”
For a decade, we have worked with patients, clinicians and other stakeholders to create a solution designed specifically to meet the challenges of mental health inpatient care.
Patients have been involved since the earliest stages of product development, when we collaborated with an NHS mental health trust to run a study with patient volunteers. Since then, we have worked with providers around the country to gather feedback from almost 400 patients whose care has been supported by Oxevision. A range of data collection methods have been used (questionnaires, interviews and focus groups) to enhance data quality and help capture a broad range of perspectives and insights.
We also work directly with an expert-by-experience advisory group on various co-production and co-design projects; for example, the group has helped us to improve the staff training we deliver on how to talk to patients about Oxevision.
Service user and carer groups are consulted during each provider’s implementation – helping to shape local clinical policies and protocols.
To learn more, click here.