Posts

Continuous Surveillance of Sleep Apnea Patients

/in /by

Peer-reviewed results of patented surveillance application reveals promise of real-time patient safety initiatives in hospitals and health systems

Milford, CT—May 24, 2017—Bernoulli, the leader in real-time solutions for patient safety, announced the publication of a peer-reviewed study demonstrating the use of patented real-time analytics, medical device connectivity and combinatorial alarms to provide remote centralized continuous monitoring of post-surgical patients at risk for opioid-induced respiratory depression (OIRD).

Continuous Surveillance of Sleep Apnea Patients in a Medical-Surgical Unit1 in the May/June 2017 issue of the Journal of Biomedical Instrumentation & Technology consists of two separate studies on the use of continuous capnography monitoring at a medical-surgical unit at Virtua Health System in New Jersey.

The study’s results suggest that combinatorial alarm signals based on multi-parameter assessment reduced overall load better than individual-parameter sustained alarm signals and appeared to be more effective at identifying at-risk patients.

Using only sustained alarms as the filter for notifications reduced alerts from 22,812 to 13,000. However, passing multiple series of data through a multi-variable rules engine that monitored the values of pulse (HR), oxygen saturation (SpO2), respiratory rate (RR), and end-tidal carbon dioxide (ETCO2) in order to determine which alarms to send to the nurse-call phone system further reduced alerts to just 209—a 99% reduction.

“More importantly, clinical staff was alerted for every patient that experienced an actual respiratory depression episode,” said the study’s co-author, John Zaleski, PhD, CAP, CPHIMS, Chief Analytics Officer of Bernoulli. “The successful implementation of real-time patient safety initiatives have long been a goal of health system CIOs, but recognizing and responding to signs of patient deterioration requires medical devices connectivity as well as clinician’s access to real-time data.”

A Growing Patient Safety Threat
The use of opioids, such as hydromorphone and morphine sulfate, are known to increase risk of respiratory depression in patients who have been diagnosed with or are at risk for obstructive sleep apnea (OSA).

More than half of medication-related deaths and 20,000 incidences of respiratory depression-related interventions annually are attributed to the delivery of opioids in a care setting, at a cost of approximately $2 billion per year to the U.S. healthcare system.

“Data from multiple sources may be required to achieve improvements in patient safety, including the EHR and real-time data from medical devices,” said Zaleski. “Moment-to-moment changes in patient vitals are not usually available in the long-term clinical record, so a hybrid approach involving both real-time and aperiodic and discrete data is required to improve the overall surveillance of these patients.”

Respiratory Depression Safety Surveillance
The solution leveraged in the study, Bernoulli’s Respiratory Depression Safety Surveillance (RDSS), includes patented analytics with multi-variable thresholds—adjustable by the care facility—to identify clinically actionable events while significantly reducing the overall number of alarms communicated to remote and mobile clinicians, mitigating the risk of alarm fatigue.

RDSS is flexible, adaptable and scalable from individual departments to enterprise-wide deployments. Its vendor-neutral architecture leverages the hospital’s existing investments in IT, network, wireless and mobile infrastructure, while its FDA class II clearance includes indications for use to provide remote monitoring and alarm surveillance.

Implications for Real-Time Healthcare
“Combining analysis with real-time data at the point of collection creates a powerful tool for prediction and clinical decision support,” said Zaleski. “The ability to track patients throughout the hospital, continuously add new devices, and distribute real-time patient monitoring to centralized dashboards and mobile devices should be a major consideration for CIOs tasked with achieving real-time healthcare capabilities.”

Beyond high-acuity areas, healthcare systems are creating a foundation for other real-time healthcare innovations, including clinical surveillance modules, medical device integration in an EHR and virtual ICUs.

“This study demonstrates the promise of using real-time data for myriad patient safety initiatives,” said Janet Dillione, CEO of Bernoulli. “In addition, Bernoulli’s RDSS solution sets the stage for a wide range of applications, including medical device integration, precision alarm notifications, and clinical surveillance modules in various care settings.”

Reference
1. Supe D, Baron L, Decker T, Parker K, Venella J, Williams S, Beaton K, Zaleski J. A pilot study in middleware-filtered capnography alarms of continuously monitored obstructive sleep apnea patient in a medical-surgical unit. BI&T. May/June 2017.

Bernoulli One™ is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, real-time analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow.

About Bernoulli

Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One™ is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, real-time analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. For more information about Bernoulli One™, visit www.bernoullihealth.com. Follow us on LinkedIn and Twitter . Visit our Resource Center to download case studies, white papers and articles.

Study: Real-Time Analytics, Continuous Monitoring Mitigates Threat of Respiratory Depression

/in /by

Peer-reviewed results of patented surveillance application reveals promise of real-time patient safety initiatives in hospitals and health systems

Milford, CT—May 24, 2017—Bernoulli, the leader in real-time solutions for patient safety, announced the publication of a peer-reviewed study demonstrating the use of patented real-time analytics, medical device connectivity and combinatorial alarms to provide remote centralized continuous monitoring of post-surgical patients at risk for opioid-induced respiratory depression (OIRD).

Continuous Surveillance of Sleep Apnea Patients in a Medical-Surgical Unit1 in the May/June 2017 issue of the Journal of Biomedical Instrumentation & Technology consists of two separate studies on the use of continuous capnography monitoring at a medical-surgical unit at Virtua Health System in New Jersey.

The study’s results suggest that combinatorial alarm signals based on multi-parameter assessment reduced overall load better than individual-parameter sustained alarm signals and appeared to be more effective at identifying at-risk patients.

Using only sustained alarms as the filter for notifications reduced alerts from 22,812 to 13,000. However, passing multiple series of data through a multi-variable rules engine that monitored the values of pulse (HR), oxygen saturation (SpO2), respiratory rate (RR), and end-tidal carbon dioxide (ETCO2) in order to determine which alarms to send to the nurse-call phone system further reduced alerts to just 209—a 99% reduction.

“More importantly, clinical staff was alerted for every patient that experienced an actual respiratory depression episode,” said the study’s co-author, John Zaleski, PhD, CAP, CPHIMS, Chief Analytics Officer of Bernoulli. “The successful implementation of real-time patient safety initiatives have long been a goal of health system CIOs, but recognizing and responding to signs of patient deterioration requires medical devices connectivity as well as clinician’s access to real-time data.”

A Growing Patient Safety Threat
The use of opioids, such as hydromorphone and morphine sulfate, are known to increase risk of respiratory depression in patients who have been diagnosed with or are at risk for obstructive sleep apnea (OSA).

More than half of medication-related deaths and 20,000 incidences of respiratory depression-related interventions annually are attributed to the delivery of opioids in a care setting, at a cost of approximately $2 billion per year to the U.S. healthcare system.

“Data from multiple sources may be required to achieve improvements in patient safety, including the EHR and real-time data from medical devices,” said Zaleski. “Moment-to-moment changes in patient vitals are not usually available in the long-term clinical record, so a hybrid approach involving both real-time and aperiodic and discrete data is required to improve the overall surveillance of these patients.”

Respiratory Depression Safety Surveillance
The solution leveraged in the study, Bernoulli’s Respiratory Depression Safety Surveillance (RDSS), includes patented analytics with multi-variable thresholds—adjustable by the care facility—to identify clinically actionable events while significantly reducing the overall number of alarms communicated to remote and mobile clinicians, mitigating the risk of alarm fatigue.

RDSS is flexible, adaptable and scalable from individual departments to enterprise-wide deployments. Its vendor-neutral architecture leverages the hospital’s existing investments in IT, network, wireless and mobile infrastructure, while its FDA class II clearance includes indications for use to provide remote monitoring and alarm surveillance.

Implications for Real-Time Healthcare
“Combining analysis with real-time data at the point of collection creates a powerful tool for prediction and clinical decision support,” said Zaleski. “The ability to track patients throughout the hospital, continuously add new devices, and distribute real-time patient monitoring to centralized dashboards and mobile devices should be a major consideration for CIOs tasked with achieving real-time healthcare capabilities.”

Beyond high-acuity areas, healthcare systems are creating a foundation for other real-time healthcare innovations, including clinical surveillance modules, medical device integration in an EHR and virtual ICUs.

“This study demonstrates the promise of using real-time data for myriad patient safety initiatives,” said Janet Dillione, CEO of Bernoulli. “In addition, Bernoulli’s RDSS solution sets the stage for a wide range of applications, including medical device integration, precision alarm notifications, and clinical surveillance modules in various care settings.”

Reference
1. Supe D, Baron L, Decker T, Parker K, Venella J, Williams S, Beaton K, Zaleski J. A pilot study in middleware-filtered capnography alarms of continuously monitored obstructive sleep apnea patient in a medical-surgical unit. BI&T. May/June 2017.

Bernoulli One™ is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, real-time analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow.

About Bernoulli

Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One™ is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, real-time analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. For more information about Bernoulli One, visit www.bernoullihealth.com. Follow us on LinkedIn and Twitter . Visit our Resource Center to download case studies, white papers and articles.

Bernoulli’s John Zaleski and Jeanne Venella co-author respiratory depression study in Biomedical Instrumentation & Technology

/in /by

This report consists of two separate studies on the use of continuous capnography monitoring conducted in an effort to improve patient safety at Virtua Health System. The desire for improved patient safety is motivating continuous monitoring and improved surveillance in clinical areas not traditionally equipped for such monitoring. We explored the use of remote monitoring of capnography, using enterprise middleware, in patients recovering from surgery in a medical-surgical unit. Continuous monitoring traditionally has been used in higher-acuity settings, such as intensive care units. Patients diagnosed or suspected to have obstructive or central sleep apnea may benefit from the increased surveillance afforded by continuous monitoring. Pain management in this cohort of patients, recovering from bariatric, joint replacement, or other major surgery, often involves administration of opioids (e.g., hydromorphone, morphine sulfate), which are known to increase risk of respiratory depression. Continuous monitoring of these patients increases the likelihood of detecting adverse clinical events. Our goal was to implement continuous monitoring in order to identify alarm conditions caused by adverse clinical events requiring intervention (e.g., opioid-induced respiratory depression) and artifacts related to patient movement, suspect measurements, or other medical device–generated alarm signals.

Read more

Bernoulli Launches Respiratory Depression Safety Surveillance ( RDSS ) Solution

/in , /by

Revolutionary New Analytics Application to Address Significant Patient Safety Threat

Milford, CT—April 3, 2017—Bernoulli, the leader in real-time solutions for patient safety, has announced a revolutionary new application for the continuous monitoring of patients at risk of respiratory depression. Bernoulli’s Respiratory Depression Safety Surveillance (RDSS) solution utilizes comprehensive real-time data to help clinicians quickly recognize and respond to signs of respiratory distress. RDSS includes exclusive analytics with multi-variable thresholds—adjustable by the care facility—to identify clinically actionable events while significantly reducing the overall number of alarms communicated to remote and mobile clinicians, mitigating the risk of alarm fatigue.

A Solution to a Growing Patient Safety Threat

More than half of medication-related deaths and 20,000 incidences of respiratory depression-related interventions annually are attributed to the delivery of opioids in a care setting, at a cost of approximately $2 billion per year to the U.S. healthcare system.1

Current monitoring practices are neither adequate nor comprehensive. For example, one of the most common methods—periodic physical spot checks by direct-care clinical staff—can leave patients unmonitored up to 96% of the time.2 Additionally, the adoption of continuous respiratory surveillance is beset by significant challenges, including reduced visual and audible oversight due to single-patient rooms and high nurse-to-patient ratios in many care areas with at-risk patients, and limitations of stand-alone respiratory monitoring devices that can have high rates of false and non-clinically actionable alarms. The disruption of direct-care clinical staff workflow also is a major barrier to continuous monitoring.

Bernoulli’s RDSS solution mitigates many of these clinical, technical and operational challenges. The platform provides connectivity to a hospital’s existing fleet of pulse oximeters and capnographs from a wide range of vendors, including Medtronic, Masimo and others. RDSS also integrates with mobile clinical communication tools to deliver the right alarms and alerts to the right caregiver at the right time.

Proven Clinical Results

In a forthcoming clinical study of patients diagnosed or at risk of obstructive or central sleep apnea, to be published in the Journal of Biomedical Instrumentation & Technology3, the use of Bernoulli’s RDSS analytics reduced 22,812 alarms generated by bedside capnographs and pulse oximeters to just 209 respiratory depression alerts delivered to mobile clinicians—a reduction of 99%. More importantly, the RDSS analytics distributed alerts for every patient that experienced an actual respiratory depression episode.

“The risks inherent in delivering opioids or patient-controlled analgesia to post-operative patients increase the possibility for sentinel events, particularly in patient populations managing chronic illnesses or co-morbidities, such as sleep apnea and obesity,” said Janet Dillione, CEO of Bernoulli. “Bernoulli’s RDSS solution effectively delivers on the recommendations of The Joint Commission, AAMI Foundation and ECRI Institute that hospitals implement continuous respiratory monitoring for these at-risk patients.”

References

  1. Overdyk FJ, Carter R, Maddox RR, Callura J, Herrin AE, Henriquez C. Continuous Oximetry / Capnometry Monitoring Reveals Frequent Desaturation and Bradypnea During Patient-Controlled Analgesia. Anesth Analg. 2007;105:412-8.
  2. Wong M, Mabuyi A, Gonzalez B. First National Survey of Patient-Controlled Analgesia Practices. Physician-Patient Alliance for Health & Safety (PPAHS), October 2013; Web page: premiersafetyinstitute.org/wp-content/uploads/PPAHS-national-survey-patient-controlled-analgesia.pdf.
  3. Supe D, Baron L, Decker T, Parker K, Venella J, Williams S, Beaton K, Zaleski J. A pilot study in middleware-filtered capnography alarms of continuously monitored obstructive sleep apnea patient in a medical-surgical unit. BI&T. May/June 2017. Manuscript in preparation.

 

About Bernoulli

Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One™ is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. For more information about Bernoulli One™, visit www.bernoullihealth.com. Follow us on Twitter and LinkedIn. Visit our Resource Center to download case studies, white papers and articles.

Bernoulli Launches Respiratory Depression Safety Surveillance Solution

/in , /by

Revolutionary New Analytics Application to Address Significant Patient Safety Threat

Milford, CT—April 3, 2017—Bernoulli, the leader in real-time solutions for patient safety, has announced a revolutionary new application for the continuous monitoring of patients at risk of respiratory depression. Bernoulli’s Respiratory Depression Safety Surveillance (RDSS) solution utilizes comprehensive real-time data to help clinicians quickly recognize and respond to signs of respiratory distress. RDSS includes exclusive analytics with multi-variable thresholds—adjustable by the care facility—to identify clinically actionable events while significantly reducing the overall number of alarms communicated to remote and mobile clinicians, mitigating the risk of alarm fatigue.

A Solution to a Growing Patient Safety Threat

More than half of medication-related deaths and 20,000 incidences of respiratory depression-related interventions annually are attributed to the delivery of opioids in a care setting, at a cost of approximately $2 billion per year to the U.S. healthcare system.1

Current monitoring practices are neither adequate nor comprehensive. For example, one of the most common methods—periodic physical spot checks by direct-care clinical staff—can leave patients unmonitored up to 96% of the time.2 Additionally, the adoption of continuous respiratory surveillance is beset by significant challenges, including reduced visual and audible oversight due to single-patient rooms and high nurse-to-patient ratios in many care areas with at-risk patients, and limitations of stand-alone respiratory monitoring devices that can have high rates of false and non-clinically actionable alarms. The disruption of direct-care clinical staff workflow also is a major barrier to continuous monitoring.

Bernoulli’s RDSS solution mitigates many of these clinical, technical and operational challenges. The platform provides connectivity to a hospital’s existing fleet of pulse oximeters and capnographs from a wide range of vendors, including Medtronic, Masimo and others. RDSS also integrates with mobile clinical communication tools to deliver the right alarms and alerts to the right caregiver at the right time.

Proven Clinical Results

In a forthcoming clinical study of patients diagnosed or at risk of obstructive or central sleep apnea, to be published in the Journal of Biomedical Instrumentation & Technology3, the use of Bernoulli’s RDSS analytics reduced 22,812 alarms generated by bedside capnographs and pulse oximeters to just 209 respiratory depression alerts delivered to mobile clinicians—a reduction of 99%. More importantly, the RDSS analytics distributed alerts for every patient that experienced an actual respiratory depression episode.

“The risks inherent in delivering opioids or patient-controlled analgesia to post-operative patients increase the possibility for sentinel events, particularly in patient populations managing chronic illnesses or co-morbidities, such as sleep apnea and obesity,” said Janet Dillione, CEO of Bernoulli. “Bernoulli’s RDSS solution effectively delivers on the recommendations of The Joint Commission, AAMI Foundation and ECRI Institute that hospitals implement continuous respiratory monitoring for these at-risk patients.”

References

  1. Overdyk FJ, Carter R, Maddox RR, Callura J, Herrin AE, Henriquez C. Continuous Oximetry / Capnometry Monitoring Reveals Frequent Desaturation and Bradypnea During Patient-Controlled Analgesia. Anesth Analg. 2007;105:412-8.
  2. Wong M, Mabuyi A, Gonzalez B. First National Survey of Patient-Controlled Analgesia Practices. Physician-Patient Alliance for Health & Safety (PPAHS), October 2013; Web page: premiersafetyinstitute.org/wp-content/uploads/PPAHS-national-survey-patient-controlled-analgesia.pdf.
  3. Supe D, Baron L, Decker T, Parker K, Venella J, Williams S, Beaton K, Zaleski J. A pilot study in middleware-filtered capnography alarms of continuously monitored obstructive sleep apnea patient in a medical-surgical unit. BI&T. May/June 2017. Manuscript in preparation.

 

About Bernoulli

Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. For more information about Bernoulli One, visit www.bernoullihealth.com. Follow us on Twitter and LinkedIn. Visit our Resource Center to download case studies, white papers and articles.