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

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

Bernoulli’s John Zaleski and Jeanne Venella co-author respiratory depression study in Biomedical Instrumentation & TechnologyJohn Zaleski, PhD, CAP, CPHIMS, Chief Analytics Officer, and Jeanne Venella, DNP, MS, RN, CEN, CPEN, Chief Nursing Officer of Bernoulli, the real-time leader in patient safety, co-authored a study demonstrating the use of patented 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).

The peer-reviewed study—Continuous Surveillance of Sleep Apnea Patients in a Medical-Surgical Unit—published in the May/June 2017 issue 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.

The solution

The solution leveraged in the study, Bernoulli’s Respiratory Depression Safety Surveillance, 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.

The study’s other co-authors include Dana Supe, MD, MBA, DABSM; Leah Baron, MD; Tom Decker; and Kyle Parker of Virtua, and Kari Beaton, RN, and Sarah Williams, RT, of Bernoulli.

Access the May/June 2017 issue of Biomedical Instrumentation & Technology here.

Follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

patient monitoring article in rt magazine alarm management

John Zaleski featured in RT Magazine cover story on alarm management for respiratory therapists

John Zaleski, PhD, CAP, CPHIMS, Chief Analytics Officer of Bernoulli, the real-time leader in patient safety, is featured in the May/June cover story of RT Magazine, “Patient Monitoring and Alarm Fatigue.”

The article notes that alarm fatigue continues to remain a significant patient safety threat and details how clinicians can mitigate this problem.

Zaleski says that hospitals and health systems need better understanding of their current state environment, including clinical workflows, patient cohorts, and assessments in order to develop comprehensive guidelines and protocols for clinical alarm management.

As for solutions, Zaleski recommends one with integration capabilities. “Combinatorial alarms take multiple sources of information and bring it together to corroborate events. This is not simply limited to data extracted in real time from patient care devices at the point of care, but also can be drawn from ancillary sources.”

Read the cover story here. A case study on Bernoulli’s success in ventilator alarm management at the Hospital for Special Care is available here.

Be sure to also follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

Bernoulli will be exhibiting at the AAMI Conference and Expo booth #1226

AAMI 2017 conference

Bernoulli will be exhibiting at the AAMI Conference and Expo.

Bernoulli will be exhibiting at the AAMI Conference and Expo. The conference is in Austin, Texas from June 9th to 12th; Bernoulli will be in booth # 1226.

The conference has long been well known as the place where innovation, connection, and advancement in medical technologies come together. It is where the very best and the very brightest join together to exchange ideas on better performance, service, improved patient safety, and better quality of life in the medical industry.

At the AAMI Conference and Expo Bernoulli One™ the company’s flagship platform will show that better results in allocation of personnel resources at reduced support costs is not only a possibility but also a reality.

Bernoulli One™ is a connected, end to end, powerful and predictive capability in analytics, robust distribution, advanced alarm management, clinical surveillance and more, all in one solution.

About Bernoulli

Bernoulli is the industry’s premier leader in real time, real life, patient care monitoring systems and data. That is because the people at Bernoulli intuitively know that a patient’s care, their safety and well being, and their continued health is their most important priority. Their efforts in dynamically programmable intelligent appliances for control, connectivity, monitoring and management reflect that.

Friendly service, professional advice, and direct answers will be on hand at the conference to help provide the solutions to improving patient safer in in real time. For more information on how we can help you please follow the link Bernoullihealth.com

For additional information on the conference go to: http://www.aami.org/annualconference/

virtua case study detailing Bernoulli One successful medical device integration and connectivity

Bernoulli case study details multi-hospital medical device connectivity

Bernoulli, the real-time leader in patient safety, has published a new case study detailing its successful efforts to bring medical device integration to Virtua, one of New Jersey’s largest non-profit, multi-hospital health systems.

Utilizing Bernoulli’s standards-based, open architecture Bernoulli One™ system enabled Virtua to bring medical device integration and connectivity across a complex healthcare ecosystem with an integrated, scalable, secure, and cost-effective web-based platform.

Virtua’s need for medical device integration and connectivity grew in part to free clinicians from writing out hundreds of patient data numbers from scores of different devices and machines every day in the course of care delivery. The health system wanted a plug-and-play medical connectivity paradigm that was uniform across different departments, could seamlessly interface with their Epic EHR, and could easily scale with the health system’s future growth.

With the conclusion of the Phase I integration in Virtua’s Perioperative Department, which includes Endoscopy, ECT and Interventional Radiology, the health system has realized complete electronic documentation, which has allowed clinicians to devote more of their time facing the patient and meeting their care needs.

Phase II will focus on Virtua’s Critical Care Unit, which includes the ICU and NICU/PICU, and will integrate the units’ physiological monitors, ventilators, anesthesia machines, smart tourniquets, and brain activity monitors.

Bernoulli One™, the company’s flagship platform, is the market’s only real-time, end-to-end, connected healthcare platform that combines comprehensive and vendor-agnostic medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into one solution.

Bernoulli’s vectored event grid architecture enables true interoperability across disparate devices, networks, and systems by utilizing dynamically programmable intelligent appliances at the network edge. The system’s granular level of patient data detail, in real-time, at the point of care for improved decision support applications while also providing flexibility for user-defined configuration and control for device connectivity, monitoring and management, results in better allocation of personnel resources and reduced support costs.

Read the case study here and learn more about Bernoulli’s medical device integration and connectivity solutions here.

Be sure to also follow Bernoulli on LinkedIn and Twitter for the latest news and updates.