JMIR Publications

ABSTRACT

Background:

Febrile neutropenia represents one of the most common oncologic emergencies and is associated with significant, preventable morbidity and mortality. The vast majority of patients suffering a febrile neutropenia episode are hospitalized, resulting in significant economic cost.

Objective:

This exploratory study implemented a remote monitoring platform including a digital infrared thermometer and a pulse oximeter with the capability to notify providers in real-time of vital signs abnormalities that could suggest early clinical deterioration, and thereby improve upon clinical outcomes.

Methods:

The remote monitoring system was implemented versus standard of care vital signs monitoring in hospitalized patients with underlying hematologic malignancies complicated by a febrile neutropenia episode in order to assess both feasibility and validity of the system.

Results:

Intraclass correlation coefficient analysis (ICC), confirmed the high repeatability and accuracy of heart rate assessment (ICC= 0.856), acting as a supplement to sole, remote temperature assessment. While the sensitivity and specificity for capturing tachycardia above a rate of 100 was excellent (88% and 97% respectively), the sensitivity of the remote monitoring system capturing temperature greater than 100 degrees Fahrenheit and oxygen saturation less than 92% was 45% and 50% respectively.

Conclusions:

Overall, this novel approach including temperature, heart rate and oxygen saturation assessment successfully provides real-time, clinically valuable feedback to providers. While the temperature and oxygen saturation lags in terms of sensitivity when compared to a standard in-hospital system, the heart rate data helps overcome some of this deficit, and as a whole, the system provides additional information that can be applied to a clinically vulnerable population. By transitioning its application to the high-risk patients in the outpatient setting, the novel system can help prevent additional healthcare utilization through early provider intervention and potentially improve outcomes.