Monitoring Critical Care Patients Outside the Traditional ICU Setting – Technology Solutions for the COVID-19 Pandemic

The impact of COVID-19 is challenging our healthcare system as never before.  Hospital resources are being stretched beyond capacity.  Even basic supplies are in short supply impacting the normal patient care routine and infection control precautions.  Hospital ICU bed capacities are being expanded to areas of the hospital not designed for patients requiring intensive care.

As we learn more about the course of the COVID-19 infection, it has become clear that sicker patients will require mechanical ventilation and a significant number of patients will develop ARDS.  ARDS is complex and can be challenging to manage, even under normal circumstances.  With the potential for significantly more patients requiring mechanical ventilation, adequate patient monitoring will be compromised adding to the challenge of caring for these patients.  Monitoring technology is key to managing the individual patient as well as prioritizing and directing resources to all patients requiring mechanical ventilation.

The Etiometry Platform provides our customers an end-to-end solution for data aggregation, data storage, and display of patient data at the bedside or remotely.   System integration is seamless and is compatible with virtually any existing medical device and clinical monitoring system already in place.  This flexible integration allows for scalability across multiple areas of care, including areas not typically used to manage ICU patients.  A unique Respiratory View provides the clinical data relevant to management of ARDS patients with the ability to customize as needed.   Trended historical patient data is included as well, providing a comprehensive clinical picture of patient condition and course of disease.

In recent weeks our technical team has expedited the release and access to features that will enhance remote monitoring capabilities to aid our customers in managing more patients with fewer staffing resources.  Added capabilities include a telemedicine display and an early release of a risk index relevant to management of ARDS.  The Telemedicine Census Display feature provides remote viewing of all ventilated patients which includes viewing of vital signs, lab values, and ventilator settings.  This can allow more efficient use of limited respiratory therapy staff resources and significantly limit staff exposure for contracting the infection. These features are being made available under the FDA’s enforcement policy for non-invasive remote monitoring devices used to support patient monitoring during the coronavirus disease (COVID-19) public health emergency.

The Risk Analytics Engine feature provides an additional level of monitoring capability by using relevant patient data to derive risk estimations for specific patient conditions.  Specifically, the IDO2 and IVCO2 indices provide insight to the risk of a compromised oxygenation and compromised ventilation respectively.  These indices are calculated and tracked continuously, providing markers of patient condition.  An early release of the IVCO2 Index was made available to our customers for immediate installation.  Installation and activation of these features requires minimal hospital technical support and can be accomplished remotely. These features are useful to clinicians under any circumstance and once installed they are rapidly scalable to address periodic surges in the need for increased patient monitoring and surveillance capabilities.

We will remain in close contact with our hospital partners and monitor the situation in our communities to anticipate needs, offer solutions, and support as best we can.