Mercy Virtual Uses mHealth Wearables to Create a New Model of Care
The nation’s first virtual care center is using mHealth wearables in remote patient monitoring programs that give care providers real-time data on patients in member hospitals. Soon that program will expand to the home.
The St. Louis-based hospital, billed as the nation’s first free-standing virtual care center, has been using VitalConnect’s VitalPatch sensor and Vista Solution platform in its hub-and-spoke telemedicine network for most of this year, enabling care providers to monitor up to eight biometric signs of patients being treated at its partner hospitals.
“We’re using technology to let us see what the patient is doing in real time,” says Mark Saxon, Mercy Virtual’s Vice President of Clinical Operations.
The VitalPatch is a disposable patch that affixes to the skin and continuously monitors single-lead ECG (electrocardiography), heart rate, heart rate variability, respiratory rate, skin temperature, body posture, fall detection and activity (steps) for up to 120 hours.
Launched out of Silicon Valley in 2011 and introducing its first disposable mHealth wearable at the Health Information and Management Systems Society (HIMSS) conference in 2016, Vital Connect was part of the early wave of mHealth developers looking to create wearable platforms that would transmit clinical-grade data to the provider without interfering with the patient’s movement. That category includes patches, wearables, smartwatches, smartglasses, even tattoos.
“Digital technologies are disrupting and transforming medicine, allowing clinicians to monitor at-risk patients 24×7 while driving proactive, personalized care,” Dr. Stephen Steinhubl, then Director of Digital Medicine at Scripps Health’s Scripps Translational Science Institute, said in a 2016 release touting the Vital Patch at HIMSS16. “The net result will be significant for improved quality of care and a more cost-efficient healthcare delivery system.”
Another ground-breaking company, Massachusetts-based MC10, emerged at the same time with a series of flexible, wearable sensor arrays – in patch form – targeted at the sports and fitness fields. The company made waves in 2013 when it announced a partnership with Reebok to develop a sensor embedded in a headband or cap to measure concussive impacts and signed high-profile athletes like NFL quarterback Andrew Luck and former MSL soccer player Taylor Twellman as spokesmen.
“BioStamps will give us new streams of data from multiple body locations synchronized in a way that lets us see correlations that we couldn’t see before,” Roozbeh Ghaffari, MC10’s co-founder and vice president of technology, said during a panel discussion at the CES show in 2016 in Las Vegas.
The VitalPatch was first put to the test in 2016 at Partners HealthCare’s Brigham and Women’s Hospital in Boston.
“We are in a very exciting era of medicine where clinical-grade biosensors and analytics are capable of delivering continuous physiological insight that was traditionally only available in the hospital environment,” David Levine, MD, a General and Internal Medicine Fellow at Brigham and Women’s who has overseen the mHealth platform’s deployment, said in 2016,
At Mercy Virtual, Saxon sees the connected care platform as a means of freeing the patient from uncomfortable and constricting wire-based sensors.
“The amount of stuff we can tether a patient to at the bedside … is almost criminal,” he says. “What we’re trying to do is get away from that.”
Just as important, Saxon says, the mHealth platform enables providers to filter out the noise. Bedside sensors send out alarms whenever the biometric signal they’re monitoring strays above or below a pre-set limit. Often those alarms are unnecessary – vital signs can be scrambled when a patient gets out of bed to talk a walk, for instance – but they still bring staff to the bedside or telemedicine console, adding to the stress levels of both patient and provider.
Saxon says wearable mHealth monitors help those monitoring the patient “see” whatever he or she is doing, enabling providers to avert needless alarms before they occur.
Saxon says the sensors are easy to attach, and have drawn positive reviews from patients so far.
“People are very receptive to it – they want to use it,” he says.
“The UX part is the most important,” Saxon says. “When you tell them you’re not going to stick a couple thousand pieces of wiring on them, they’re generally going to accept it.”
Likewise, he says both patients and providers are reassured by the fact that the device is an FDA-approved Class 2 device. The health system could have gone with a consumer-facing wearable that might be more stylish, but wouldn’t give providers access to clinical-grade data.
Saxon says some of the most popular wearables can present data that’s 40 percent off the mark.
“We could kill somebody with that much of a variance,” he says.
In January 2019, Mercy Virtual will push this monitoring platform out of the hospital and into the home. The health system will be launching a new program that equips patients dealing with congestive heart failure and pneumonia with the VitalPatch sensor, enabling care teams to monitor those patients’ vital signs while they’re at home, going about their everyday lives.
Saxon says the health system has occasionally sent a patient home with the mHealth wearable, but this will be the first test of the platform on specific patients with specific diagnoses. The long-term goal, he said, is to expand the “hospital-to-home” program to 16 different diagnoses.
mHealth programs like this, he says, are part of the health system’s shift from reactive healthcare to “predictive or proactive healthcare.” By synching with smart devices in the home and integrating with the hospital’s electronic health platform, these technologies can give providers a real-time view of their patients. Add in AI technology, and the platforms can help providers identify health concerns before they become serious and intervene.
“What we’re trying to do is tie all of this together,” Saxon says. “We’re looking to intertwine programs and create a central model of care.”