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Healthcare monitoring must move into the modern electronic era



Professor Malcolm Green explains why he believes the NHS is missing an important opportunity for non-contact patient monitoring.


It is over a year since Health Secretary Jeremy Hunt challenged the NHS is to go paperless by 2018, yet almost every day there is a new story about how the health service is struggling to achieve this goal.  Security challenges, cumbersome IT systems, and many other obstacles stand in the way of this worthwhile objective; however, there is one good-news story because a new technology can now move patient monitoring into the modern electronic era.


With the exception of Urgent and Critical Care units, a walk around most wards will highlight how routine patient monitoring in hospitals is still in post WW2 mode. In fact, not a lot has changed since Florence Nightingale's time; a nurse measures the temperature, pulse and respiratory rate (TPR) of a patient every three to four hours or so and manually records the results on a paper chart. Non-contact vital sign monitoring has the ability to revolutionise these methods.


The good news is that a non-invasive, non-contact method for continuous monitoring is now available. Oxehealth has developed the Oxecam. This camera takes the science of photoplethysmography (PPG) and, through the use of sophisticated algorithms, reads vital signs with no patient contact whatsoever. This information can then be uploaded into patient records, saving  the labour of manual recording and removing opportunity for human error.


Preliminary data from studies in the  Renal Unit and Neonatal Unit at Oxford indicate that the accuracy of camera-derived estimates of heart rate and breathing rate is similar to that obtained with a conventional intensive care patient monitor.


An example of savings that can be made using this technology is in the instance of a maternity unit.  At present, a typical unit will have 30+ neonates that need to be monitored.  It takes at least a couple of minutes to take the measurements for each infant, then a few minutes to find the notes and record the results.


This process is repeated every 3 hours, and taking an optimistic time of 5 minutes per baby in total, simple maths demonstrates that these essential measurements require the equivalent of the whole-time attention of a fully qualified health professional. As the recordings are required 24 hours per day, and allowing cover for annual leave/sickness etc, this equates to 5 or 6 full time professionals. The cost in time and money becomes significant, a cost which can be extrapolated throughout the NHS.


This approximation does not even include the additional time and materials to minimise the risk of cross-infection nor the repeated disturbance to the patient.


The immediate financial benefits of introducing non-invasive continuous monitoring are pronounced, and there are further, less conspicuous long term savings: improved nursing ratios, more skilled time for patient care, reduced administration, better trend analysis, and more.


In his statement, Jeremy Hunt claimed that a paperless NHS would "save billions, improve services and help meet the challenges of an ageing population." It is with the fearless introduction of world-class healthcare innovations that such a challenge can be met.