By VICKI ALLEN
Dr. Fabian Fregoli recalls a patient who took off her oxygen mask to get out of bed to go to the restroom. As her oxygen level dropped, St. Joseph Mercy Oakland's innovative monitoring and communications system alerted her nurse, who rushed to the room and returned the patient safely to her bed and oxygen.
"And that patient did great. You think what could have happened if we didn't have that monitoring available," Fregoli said, noting the patient could have blacked out or fallen if not for the Intelligent Care System.
Connie Parliament, clinical program director of neuroscience services at St. Joseph Mercy Oakland in Pontiac, Mich., sports a ViSi Mobile wrist monitor, technology that continuously monitors a patient's vital signs.
The web of technologies is built into the Pontiac, Mich., hospital's 204-room south patient tower that opened in 2014. It includes wristworn devices that continuously monitor patients' vital signs and a system that constantly interprets the data, smartphone-based communications, smart beds that relay information to caregivers, hand hygiene-monitoring to reduce infections, and other technologies that work together to improve care and safety of patients outside of the intensive care unit.
With the integrated system, patients have direct access to their care plan information including medications and procedures, and can offer instant feedback on hospital services.
Fregoli, vice president of quality and patient safety and chief medical informatics officer at St. Joseph Mercy, helped design the system that uses a mix of technologies and vendors. Some of the technology was readily available, but some, such as the ViSi Mobile by Sotera Wireless — the device patients wear on their wrists to monitor vital signs — was cutting edge and in the process of getting Food and Drug Administration approval when the hospital began to work it into its care system.
During a trial year of use in one of the hospital's units, the unit showed a sharp reduction in code blue episodes, he said. "They identify problems before they actually happen. It is sort of pushing the envelope on improving quality and safety."
The CenTrak real-time location system monitors staff performance in hand hygiene, resulting in a sharp drop in the spread of infections. "This is a way of ensuring that people wash their hands," Fregoli said.
The Visensia early detection monitoring system interprets vital sign data to help identify changes in patients' conditions for quicker intervention. This means doctors "at a glance can identify who it is that needs more attention," Fregoli said. "It helps physicians in the risk stratification of their patients."
Doctors can use touch screens to find where their patient is located, the nurse and care assistant assigned to the patient, and diagnosis and other information. With communications through smartphones, overhead paging is eliminated.
Fregoli said patients and hospital staff have embraced the technology.
"Not only are we able to monitor our patients more closely, but it makes the day run smoother," said Sarah Simon, clinical leader in the orthopedic unit, located in the south patient tower.
Immediately after surgery, patients' vital signs must be taken every 30 minutes, then every hour and eventually every four hours, Simon said.
The ViSi Mobile wrist monitor provides constant updates. "Plus we're not having to wake (patients) up every half hour and every hour to get their vitals. Patients' number one complaint after surgery is not being able to get enough sleep," Simon said. "We're checking in on them, but we don't have to wake them up."
The device also eases stress of patients, who can tap it and see how they are doing, she said.
Fregoli said, "I've talked to patients who said they feel more secure knowing someone is watching them all the time. As much as you trust an organization, there's a lot of foreign stuff going on, a lot of anxiety about the diagnosis or the outcome, whatever the case may be. We try to alleviate as much anxiety for the patient as possible."
Fregoli and Simon emphasized that the technology does not replace human interaction with patients, but instead frees up more time for staff to provide care.
"It's actually improved patients' satisfaction; it's improved staff satisfaction. They just have more time to spend with patients," Simon said.
"Sometimes you get the perception it's a very high-tech place, but where's the touch? We still pride ourselves in being very hightouch, and the technology is there to support," Fregoli said.
The system lets the hospital more quickly respond to patients' needs, he said. For example, patients have three separate call buttons — for pain, bathroom assistance and a general nurse's call.
"When the patient presses the pain button, that goes directly to the nurse. So it bypasses the whole process of someone having to figure out who to call," he said. "We're trying to streamline and get the patients' needs met as soon as possible because minutes matter when you're in pain or have to use the bathroom or whatever."
The Intelligent Care System has caught the attention of other hospitals and has received a number of accolades, including the American Hospital Association naming St. Joseph Mercy one of three "Most Wired Innovator Award Winners" for 2015.
Fregoli said other hospitals frequently ask for site visits to check out Intelligent Care and other technologies at St. Joseph Mercy.
"We've been kind of overwhelmed with requests from really great organizations from across the country, big and small," he said. "We're of a mind-set that we're here to share. Everybody is taking care of patients and even our competitors in our market have done site visits."
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