An integrated care solution for the electrocardiogram monitoring

PurposeThis 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/approach51 patients admitted for stroke workup...

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Bibliographic Details
Published in:Journal of integrated care (Brighton, England) England), 2021-02, Vol.29 (1), p.61-71
Main Authors: Chow, Josephine S.F, Hopkins, Andrew, Dimitri, Hany, Tie, Hui, Williams, Rachael, Rajaratnam, Rohan, Gopinath, Sumana, Lazarovska, Suzana, Andrijevic, Stanica, Premawardhana, Upul, Gonzalez-Arce, Veronica E, McDougall, Alan
Format: Article
Language:English
Subjects:
Atrial fibrillation
Cardiac arrhythmia
Cellular telephones
Continuity of care
Data collection
Efficacy
Electrocardiography
Electrodes
False positive results
Health care
Heart failure
Hospitals
Integrated care
Integrated delivery systems
Nursing
Patient satisfaction
Patients
Questionnaires
Stroke
Technology
Telemedicine
Ultrasonic imaging
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Summary:PurposeThis 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/approach51 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.FindingsPatients (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/implicationsThe 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/valueThe 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.
ISSN:1476-9018
2042-8685
DOI:10.1108/JICA-04-2020-0018