An integrated care solution for the electrocardiogram monitoring
ISSN: 1476-9018
Article publication date: 6 July 2020
Issue publication date: 5 February 2021
Abstract
Purpose
This study has demonstrated how technology may contribute to integrated care solutions by comparing conventional ward telemetry (WT) to a wearable ECG monitor (S-Patch) to detect atrial fibrillation (AF) in patients with stroke.
Design/methodology/approach
51 patients admitted for stroke workup were recruited across two major tertiary centres to compare WT monitoring for two days versus S-Patch for four days in the detection of AF. The efficacy to detect AF using both technologies was assessed via data extractions and medical officer review. A matrix was used to measure nursing/patient satisfaction and setup/resource times were assessed.
Findings
Patients (84–94%) and nursing staff (75–95%) preferred the S-Patch wearable technology. Non-parametric tests indicated significant time saving for removal of S-Patch versus WT [2.2 min vs 5.1 min (p = 0.00)]. Efficacy of S-Patch to detect AF following medical officer review was greater than WT, with seven patients identified with AF by S-Patch versus one using WT. The S-patch had a false positive rate of 78%.
Research limitations/implications
The S-Patch is sensitive in the detection of AF; however, it showed a high false-positive rate with automated reporting. This study has provided insight into the details of delivery of integrated healthcare using wearable technology.
Originality/value
The technology and partnership were the first-in-kind in Australia. The S-Patch had a higher detection rate of AF compared to WT which allows patients to be anti-coagulated appropriately for the prevention of further stroke. The results of this study will be ideally placed to inform future policy in integrated healthcare using new technologies.
Keywords
Acknowledgements
The authors would like to acknowledge the team at the South Western Sydney Local Health District Clinical Innovation & Business Unit who assisted with the project management. We would specially like to thank all the nursing staff from the Neurology Wards at Liverpool Hospital and Camden/Campbelltown Hospital, who provided honest responses to the study questionnaires and assisted the team with the daily management and care of recruited patients. Lastly, we would like to acknowledge the patients who participated in this study and thank them for allowing us to work with them and for their authentic feedback and interest in trialling this new technology.
Citation
Chow, J.S.F., Hopkins, A., Dimitri, H., Tie, H., Williams, R., Rajaratnam, R., Gopinath, S., Lazarovska, S., Andrijevic, S., Premawardhana, U., Gonzalez-Arce, V.E. and McDougall, A. (2021), "An integrated care solution for the electrocardiogram monitoring", Journal of Integrated Care, Vol. 29 No. 1, pp. 61-71. https://doi.org/10.1108/JICA-04-2020-0018
Publisher
:Emerald Publishing Limited
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