For perfusionists, useful, relevant data is essential. Real-time data, with the capability to view and review events recorded at any time during a procedure, can be even more useful. Ideally, real-time perfusion systems capture, analyze, and report data—especially unexpected or abnormal parameters—back to a clinician, at or near the moment they occur in the patient’s body. In this way, valuable, life-saving alert systems can be developed.
Real-time alert systems are especially useful in clinical situations where a patient’s condition can change within seconds or minutes, such as during cardiopulmonary bypass (CPB) surgery. Other scenarios where physiologic conditions fluctuate and change rapidly include critical care and emergency units. Real-time clinical data obtained in all these areas can be used to improve the quality of care.
Additionally, this type of data adds substantial value to any patient’s electronic health record (EHR). By the same token, the EHR may be the vehicle upon which funding for real-time systems may be procured.
Real-Time, Real World
How does real-time monitoring affect the quality of care? More and more ECMO teams are using real-time patient monitoring on mobile devices to effectively deliver optimal patient outcomes. Timely alerts and automatic updates to the patient’s medical record are proven to be beneficial in the support of clinical needs as ECMO therapy requires constant supervision and vigilant safeguards for long periods of time.
The average reaction time in the group using the alerts was 3.6 seconds. The average reaction time in the control group was nearly ten times longer than the group using computer-assisted, real-time data feedback.
For continuous blood gas measurement, another study revealed blood gas levels of CPB patients in the continuous monitoring group were able to be maintained in accordance with protocol a greater percentage of the time (e.g. pCO2 management was 20% versus 2% in the control group).
Electronic Health Records & Funding Real-Time Initiatives
A wide range of real-time perfusion monitoring systems exist, and they all provide interconnectivity to electronic medical (health) record (EMR or EHR) systems via WiFi, Ethernet, or other wire-based network connections. The system used in the Columbia study enables compliance alerts for parameters, such as mean arterial pressure, temperature flow, cardiac index, blood gases, saturation, Hct, PO2, and CO2.
While fidelity to electronic health records is vital in the modern age, interconnectivity can also be leveraged into funding sources.
Since 2011, the Centers for Medicare & Medicaid services established the Medicare and Medicaid EHR Incentive Programs. Stage 2 focuses “on advancing clinical processes and ensuring that the meaningful use of EHRs supports the aims and priorities of the National Quality Strategy. Stage 2 criteria encouraged the use of CEHRT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible.”
In this context, real-time monitoring solutions are an attractive option to improve perfusionist performance, impact the quality of care, and modernize any health care center’s cardiopulmonary bypass-based services.
Will Real-Time Monitoring Technology be a Game Changer for Perfusion Safety? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474898/
Real-time data acquisition and alerts may reduce reaction time and improve perfusionist performance during cardiopulmonary bypass https://journals.sagepub.com/doi/abs/10.1177/0267659114548257