Ramaiah Memorial Hospital uses remote monitoring during COVID-19

Through a remote patient monitoring system, Ramaiah Memorial Hospital in India is able to immediately attend to COVID-19 patients with comorbidities and at the same time successfully implement hospital infection control.

Ramaiah Memorial Hospital (RMH) is an early adopter of remote patient monitoring. Since 2017, the hospital has been using smart remote monitoring solution for post-ICU shift-outs and in cases of accelerated hypertension, chronic obstructive pulmonary disease, heart failure, and bronchial asthma.

Recently, the use of such monitoring system allowed RMH to perform effectively in its pandemic management. In an interview with Hospital Insights Asia, Dr Anil Kumar, Head of Department, General Medicine and Head of COVID Response Team, Dr Arun M S, Associate Professor and Assistant Hospital Administrator, and Dr Jolly Anil John, Assistant Professor, General Medicine, share how RMH utilises a remote patient monitoring system to care for patients and their healthcare staff.

During a pandemic

The remote patient monitoring system that RMH uses is able to measure six key vital parameters in a single monitor, allowing clinicians to view a patient’s heart rate, oxygen saturation, electrocardiogram, respiratory rate, non-invasive blood pressure, and skin temperature. All these data can be monitored in real time and in any location via a smartphone application.

When COVID-19 happened, RMH turned to this very same remote monitoring system for moderately to severely ill COVID-19 patients. The monitors attached to the patients help doctors and nurses receive frequent notification about the key vital parameters that are colour-coded for quick evaluation. For instance, a doctor can easily view a patient’s heart rate and decide to call a nurse if the button turns yellow. If the button is green in colour, it means the patient’s certain parameter is stable. Hence, healthcare providers are easily alerted if there is any deterioration in the patient’s health, thereby, allowing them to take immediate action.

Moreover, using a remote patient monitoring system at a time like COVID-19 enabled RMH to still provide its patients with individual care despite a large number of patients to attend to. Using the straightforward colour-coded display and automatic early warning scores on the monitor, nurses efficiently triaged patients.

Having remotely monitored isolation wards also allowed RMH to protect its healthcare staff from contracting the infection. Suspected and confirmed cases of COVID-19 are managed remotely, thus, requiring lower PPE supply for doctors and nurses and enabling better hospital infection control strategy. In the same way, it also helps RMH protect other hospitalised patients.

From the patients’ perspective, the use of remote monitoring was a welcome approach. According to Dr Kumar, “anxious patients seem more comfortable using the device because they feel they are better cared for.”

A few concerns

While doctors and patients find the use of remote monitoring devices useful, there are always some concerns surrounding their use in healthcare.

For one, patients complain about related disturbances from the device, such as the noise and the wires connected to their bodies. Since the device has an alarming sound, patients’ sleep is oftentimes disrupted. Likewise, the multiple wires attached to them make turning difficult. In these scenarios, it is then necessary for healthcare providers to constantly monitor patients’ comfort besides their health status.

Another concern is on the cost incurred from using these remote monitoring devices. Since insurers usually do not cover the use of such devices, some patients are burdened with the daily charges for the use of the device.

There is also an issue about the accuracy of online patient monitoring. Patients can be quite subjective on their complaints, and the objectivity of doctors in virtual consultations can be another factor.

With regard to data security, however, RMH is confident that the system they use complies with the provisions of the Information Technology Act, 2000 in India, which govern the transfer and storage of sensitive personal information in online channels.

Overall, RMH showed that remote patient monitoring can be agreeable to patients and can elevate the quality of care in a hospital, even and especially during a pandemic like COVID-19.