JMIR Publications

ABSTRACT

Background:

Remote vital sign monitoring of acute hospital at home (aHAH) patients is recommended in policy without clear guidance on implementation. While such monitoring has the potential to improve patient care, there is limited evidence for its feasibility and acceptability.

Objective:

We aimed to pilot the use of a remote, community-based monitoring system using a vital sign wearable patch and pulse oximeter in aHAH patients. We also explored the remote monitoring of blood pressure (BP) and temperature in this patient group.

Methods:

In this feasibility study, participants were asked to wear a chest patch to estimate their heart rate and respiratory rate (passive monitoring), and to intermittently check their oxygen saturations, blood pressure and temperature (active monitoring). Eligible patients were aged 18 years and older with an acute illness requiring aHAH care. Pregnant women and those with contraindications to monitoring were excluded. Participants were monitored for up to 7 days and asked to complete a technology assessment questionnaire. The primary outcomes were the proportion of 4-hour monitoring windows with a recorded heart rate and 12-hour daytime windows with a recorded oxygen saturation level.

Results:

In total, 25 participants completed the study, 600/674 (89.0%) of the 4-hour monitoring windows had a heart rate and 508/674 (75.4%) had a respiratory rate recorded. For the 12-hour daytime windows, 75/129 (58.1%) had an oxygen saturation, 70/129 (54.3%) had a blood pressure and 66/129 (51.2%) had a temperature recorded. Data coverage was higher for the passive monitoring compared to the active monitoring. Most participants with capacity found the combined monitoring system easy to use and thought it was useful for their healthcare.

Conclusions:

Remote monitoring of vital signs in aHAH patients is feasible and acceptable to patients. Good data coverage was achieved for the passive monitoring which did not require specific actions by the participants or their caregivers. Further work is required to ascertain which patients would benefit most from this monitoring.