Study: Remote Heart Monitoring Can Help Detect Emergencies

A new study, published in the Aug. 2 JAMA, suggests it may be beneficial for hospitals to use off-site technicians to monitor their patients’ cardiac activity. Researchers say this remote approach could prove more reliable in some cases than positioning the traditional heart monitor with noisy alarms next to the patient’s bed.

One of the primary reasons the study cites for this claim is the high volume of false alarms caused by bedside heart monitors.

According to David Cantillon, a researcher at the Cleveland Clinic in Ohio and the study’s lead author, “Important warning signs are often missed among a large volume of nuisance alarms. This is referred to as alarm fatigue, and this has been associated with serious adverse outcomes, including patient deaths across the United States."

Cantillon and his colleagues studied the benefits of remote heart monitoring by examining the outcomes for more than 99,000 cardiac patients at Cleveland Clinic and three other regional hospitals. All of the patients in the study were remotely monitored, and none of them were in critical condition or receiving intensive care.

The off-site technicians monitored up to 48 patients at a time from a remote central facility. They informed hospital staff when an alarmed was triggered that indicated there might be a problem.

Over the course of the 13-month study, the off-site technicians alerted hospital staff more than 410,000 times. Half of the notifications were due to changes in blood pressure or heart rhythm.

In approximately 3,200 cases, an emergency response team (ERT) was activated. Of those cases, 980 instances involved an alert of a blood pressure or heart rhythm change an hour or less beforehand. The majority of alerts, namely 79 percent, were accurate emergency notifications where the patient required urgent attention.

The off-site technicians also alerted ERTs about the worsening condition of 105 patients that required immediate intervention. Twenty-seven of these cases involved advanced warning of cardiopulmonary arrest. All but two of those cases resulted in a return of circulation.

Researchers found that the remote monitoring also resulted in a 16 percent decrease in the number of patients requiring monitoring at a time.

The off-site monitoring also resulted in slightly less cardiac arrests. There were 122 during the 13 months of the study versus 126 in the 13 months prior to the study.  

The study’s authors say that the observational design of the study made it impossible to determine whether remote monitoring directly caused the specific outcomes.

In order to prove a benefit, they would need to randomly monitor some patients on-site and others remotely according to Dr. Sumeet Chugh, director of the Heart Rhythm Center at Cedars-Sinai, Los Angeles.

Chugh, who was not involved in the study, says the findings, however, suggest that remote monitoring could benefit patients.

"The goal is to catch any warnings or abnormalities early, so that critical events such as heart or lung arrest can be either prevented, or managed rapidly."

To learn more, you can read the full study here.