How a remote cardiac telemetry service can minimize health system resource burdens and simplify care

In the United States, heart disease is the most common chronic disease and remains the leading cause of death for both men and women, making the ability to provide accurate continuous cardiac monitoring essential for many hospitalized patients.

Today, most hospitals and health systems have adopted some form of continuous cardiac monitoring technology known as cardiac telemetry. This technology aids patient care teams with real-time recognition of cardiac waveform changes and allows for timely response, treatment, and intervention when needed.

Following American Heart Month this past February, it is an appropriate time to highlight how continuous cardiac monitoring via a telemetry service offering can enhance the way a hospital and its bedside team pursue better clinical outcomes by optimally structuring cardiac monitoring.

Hospitalized patients being treated for certain medical conditions, patients with cardiac related co-morbidities and patients on certain medications during hospitalization are at higher risk for cardiac related events. Attempting to provide the appropriate level of monitoring to these individuals, while caring for the larger patient population, can create a significant burden on care team resources. Overburdened clinicians are more likely to overlook an important change in patient condition which can also lead to sub-optimal response times or failure to rescue events.

In order to address these challenges, hospitals have taken proactive steps to ensure early recognition of cardiac changes for those patients at highest risk by using in-patient cardiac telemetry monitoring. Telemetry models can vary. While some traditional models use nurses to monitor heart rhythms for at-risk patients in their care and follow up on the alerts and alarms spurred by automated monitoring systems, a centralized telemetry program utilizes technicians to continuously monitor, interpret, and recognize cardiac waveform changes for an assigned group of patients. A high-quality telemetry program includes trained telemetry technicians who provide real-time interpretation and immediate notification to the appropriate nurse or physician of true observed irregularities. This allows the nursing staff to focus on providing patient care. Clinical effectiveness can be improved through this service partnership by minimizing unnecessary interruptions for the nursing staff related to false or clinically insignificant alarms, thereby reducing the chance of alarm fatigue which can lead to clinician mistakes. This approach enables the hospital’s care team to intervene quickly when necessary to treat a true cardiac related event, to avoid waste related to the management of false alarms, and to assist with early recognition and treatment of clinical deterioration for monitored patients.

Recognizing the Value of Off-Premise Telemetry Partnerships
Centralized cardiac telemetry monitoring is typically accomplished by outfitting the patient with a portable telemetry pack that continuously transmits an electrocardiographic waveform to a monitoring center which is staffed with trained telemetry technicians who constantly monitor the data from a number of patients. The challenges of building or implementing a telemetry program with continuous monitoring within a hospital setting are significant. Substantial start-up efforts related to program planning, implementation, workflow development, hiring, and extensive training are required. Even more challenging is the on-going management and 24/7 staffing of the telemetry program, which includes near-constant recruitment, on-going training, and detailed management of an hourly workforce.

As an alternative to building their own telemetry program, hospitals and health systems now have the opportunity to look to an off-premise telemetry partner to provide their telemetry monitoring capability. Advanced ICU Care introduced such a telemetry service two years ago and now provides 24/7 cardiac monitoring to a number of hospitals. Trained and certified telemetry technicians located in a care center outside of the hospital are equipped to monitor and analyze the patient data that are collected. This approach to telemetry provides hospitals with 24/7 monitoring that actively tracks the heart rhythms of at-risk cardiac patients and provides in-the-moment notification to the bedside team remotely.

An off-premise telemetry partnership allows for consistent program management while moving the telemetry solution outside the four walls of the hospital. Such a solution significantly reduces the associated administrative burdens to hospital staff while ensuring a consistent level of patient monitoring quality. Rapid identification and communication of cardiac abnormalities is enabled using the same monitoring and communication technologies that empower an internal telemetry function. Relying on a dedicated telemetry service provider allows bedside care teams to treat their patients with immediate care needs as a first priority and alleviates the drain on their time that arises from managing the telemetry function.

As the incidence and cost of cardiovascular care continues to rise across the U.S., hospitals will continue to seek to implement telemetry service offerings in the most efficient way possible to free up care teams to focus on providing the highest value care. Partnering with a dedicated cardiac telemetry service such as Advanced ICU Care eliminates a hospital’s need to create, manage and sustain its own fully dedicated 24 x 7 internal continuous cardiac monitoring program. In addition, it can benefit from a flexible cost structure that adapts to the ever-changing patient census, rather than finding services constrained by staffing availability or overstaffing to anticipate maximum patient capacity.

Cardiac telemetry monitoring is an important evolution which enables hospitals and health systems to maintain outstanding care while focusing nursing resources on needed patient care rather than routine monitoring. Off-premise telemetry is a further evolution which relieves the hospital of significant administrative effort and offers efficiency and performance improvements.

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