Dallas VAMC Tests Wireless Monitoring of Vital Signs; Rollout to Full VA Possible

DALLAS — The ability for VA hospitals to remotely track the vital signs of patients has been around for longer than a decade, but it always has been limited by cost and technology.

Patients who need remote monitoring were relegated to specific areas of the hospital where that service was available. But a new system recently employed at the Dallas VAMC may mean that the hospital will be able to track patients throughout an entire facility using the hospital’s existing wireless Internet network.

Existing patient-worn monitoring technology at VA hospitals requires a dedicated wireless medical telemetry system (WMTS) band — a proprietary medical band controlled by an antennae system installed wherever a hospital wants to monitor patients.

According to Rick Sullivan, vice president of Draeger Medical — the company installing the new system at the Dallas VAMC — this older technology was tedious to install and expensive to maintain.

“Most hospitals only have one or two wards equipped for this kind of monitoring. It limits them,” Sullivan said. “For instance, if you have an oncology patient but they have a cardiac issue, they’re OK to be discharged from the ICU, but they still need to be monitored. Traditionally, they would have to go to a dedicated telemetry ward, whether it was the oncology specialty ward or not.”

As hospitals have maintained this monitoring system, Wi-Fi technology has grown around it — a much simpler and cheaper way of wirelessly gathering data.

“We are now able to do this kind of patient monitoring using Wi-Fi,” Sullivan said. “Most hospitals have Wi-Fi installed throughout their facilities. That means you can do wireless patient monitoring anywhere in the hospital. There’s an advantage to that, especially in places like VA who are bursting at the seams with patient load.”

Monitor Patients Anywhere

Patients no longer will have to wait in the emergency department until a bed in a telemetry ward opens up, Sullivan said. “The same is true of the ICU. You can get patients out of the ICU and monitor them anywhere. Before, patients ended up with longer ICU stays than should be normal.”

Older telemetry systems are little more than “a dumb box,” Sullivan said. “With traditional telemetry, it’s just a transmitter, a little box about the size of a cigarette pack, and there’s no display at all. There’s no waveform or anything. It’s just picking up the signal off the patient’s ECG and sending it back to a central station, and there’s a technician there monitoring the feeds for all the patients.”

The Draeger Infinity M300 — the device worn by patients in Dallas — has a screen displaying the waveform. “So, if a nurse is caring for a patient on the ward, and they want to see what’s going on with the patient from a cardiac standpoint, they can look on the screen. It’s not just telemetry. It’s actual patient-worn monitoring.”

The system also is cheaper to maintain and install. The previous system at Dallas went through batteries on the patient-worn devices every eight hours or so, while the Draeger system uses rechargables. “It’s better for the environment and cost savings for the hospital,” Sullivan said.

The rollout of the Draeger technology at the Dallas VAMC hit a major security road bump midway through the process.

To transfer data over a wireless Internet system, the government requires a special data encryption called Federal Information Processing Standard (FIPS) 140-2. The Dallas VAMC had purchased the monitoring system but was delayed because the system was not FIPS-compliant. Dallas applied for a waiver, but there was no immediate response.

Then it was announced that Roger Baker, VA’s chief information officer, was allowing VA employees to use iPads and iPhones to access patient data. The decision was met with some controversy, but an investigation by the Government Accountability Office found that, despite the technology not being FIPS-compliant, it was safe.

“We went back to them and said, ‘This is a VA-controlled medical device. It’s far safer than an iPad,’” Sullivan said. “So they granted us a waiver that’s applicable nationally.”

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