Inadequate monitoring of vulnerable patients can lead to missed early intervention opportunities and avoidable deaths. To fill this gap, patients are starting to play a more active role in their own healthcare, including monitoring their own vital signs. The EU-funded NIGHTINGALE project developed an intelligent, wireless patient monitoring system that picks up signs of worsening health. The system allows care teams to remotely observe patients, both on hospital wards and when discharged to their homes. The NIGHTINGALE team, a consortium of partners in medicine and industry, successfully developed and tested the ‘Checkpoint Cardio’ system, which captures a complete set of vital signs such as those taken by nurses on a hospital ward, and provides an easy communication method for carers to contact patients when concerned, and vice versa. “The results showed that wearable wireless monitoring can detect patient deterioration at an early stage,” says Cor Kalkman, emeritus professor of Anaesthesiology at the University Medical Centre Utrecht.
Developing the system with the help of industry partners
Through the EU’s Pre-Commercial Procurement strategy, the NIGHTINGALE team put the call out to industry to develop new wearable technology that could help monitor vulnerable patients. From the 125 companies that took up the challenge, the team narrowed entries down to four prototypes. The team then trialled the one system they deemed ready for testing with hospitalised, high-risk surgical patients. The newly developed Checkpoint Cardio system is a suite of wireless wearable sensors, which can accurately track heart rate, ECG (a recording of the heart’s electrical activity), respiratory rate and temperature. Algorithms process vast amounts of data captured through the sensors to find trends and warning signals, before alerting medical staff.
Lessons learned through hospital trials
Most of the NIGHTINGALE team are nurses and medical practitioners, meaning that during the pandemic many had to work extra shifts in intensive care. “Despite delays due to COVID-19, we managed to complete a clinical evaluation of the Checkpoint Cardio system in five European hospitals,” adds Kalkman, NIGHTINGALE project coordinator. The team tested the system with 25 high-risk patients from each of the five hospitals. They compared it to regular hospital monitors, observing how well it spotted trends within the vital signs, and generated scores for deteriorating health. Aside from promising initial results, the team also learned that a system of this kind can’t simply be dropped into existing clinical settings, but requires shifting work flows for nurses on the wards.
Ambitions for a larger project fostered through the pandemic
Because of the experience through the COVID-19 pandemic, the team realised that this system could help with a general transition towards earlier patient discharge, with increased remote monitoring at home. This would relieve strain on intensive care units and hospital wards, particularly when under similar pressure faced by many hospitals across Europe over the past couple of years. The NIGHTINGALE team are now actively exploring opportunities for a larger project including more European hospitals. “We will implement these novel systems in clinical practice, including performing initial tests of the embedded clinical decision support systems, and providing the large amount of clinical data needed to create self-learning systems,” Kalkman explains.
NIGHTINGALE, patient, care, sensor, wearable, vital, signs, nurse, monitoring, algorithm, data