Search

Background: Remote monitoring of mean arterial blood pressure (MAP), heart rate (HR) or oxygen saturation (SpO2) remains a challenge in outpatient surgery. This study evaluates a new digital technology (Smart AngelTM) for remotely monitoring hemodynamic data in real time: data transmitted from the patient's home to a central server, using a dedicated web-based software package.Methods: Adults scheduled for elective outpatient surgery were prospectively enrolled. In the first 5 postoperative days, patients completed a self-report questionnaire (pain, comfort, nausea, vomiting) and recorded SpO2, HR and MAP via two wireless Bluetooth monitors connected to a 4G tablet to transmit the data to a website, in real time, using Smart AngelTM software. Before transmission to the website, these data were also self-reported by the patient on a paper form. The primary outcome was the proportion of variables (self-monitored physiological data + questionnaire scores) correctly transmitted to the hospital via the system compared with the paper version.On Day 5, a system usability scale survey (SUS score 1-100) was also attributed.Results: From May 2018 to September 2018, data were available for 29 out of 30 patients enrolled (1 patient was not discharged from hospital after surgery). The remote monitoring technology recorded 2038 data items (62%) compared with 2656 (82%) items recorded on the paper form (p=0.001). The most common errors with the remote technology were software malfunctioning when starting the MAP monitor and malfunctioning between the tablet and the Bluetooth monitor. No serious adverse events were noted. The SUS score for the system was 85 (68-93) for 26 patients. Conclusion: This work evaluates the ability of a pilot system for monitoring remote physiological data using digital technology after ambulatory surgery and highlights the digital limitations of this technology. Technological improvements are required to reduce malfunctioning (4G access, transmission between apps).Trial registration: ClinicalTrials.gov (NCT03464721) (March 8, 2018)

BackgroundRemote monitoring of mean arterial blood pressure (MAP), heart rate (HR) or oxygen saturation (SpO2) remains a challenge in outpatient surgery. This study evaluates a new digital technology (SmartAngelTM) for remotely monitoring hemodynamic data in real time.Methods Adults scheduled for elective outpatient surgery were prospectively enrolled. In the first 5 postoperative days, patients used a tablet three times a day to complete a self-report questionnaire (pain, comfort, nausea, vomiting) and two wireless Bluetooth monitors (oximetry for SpO2 and HR; MAP) connected to a 4G tablet that transmits data to a website, in real time, using SmartAngelTM software. Before transmission to the website, these data were also self-reported by the patient on a paper basis. The primary endpoint was the number of data recorded in the website using the app compared to paper basis. A system usability scale survey (SUS; score 1-100) was performed at day 5.Results From May 2018 to September 2018, data were available for 29 out of 30 enrolled (1 patient failed to discharge at home after surgery). The paper-basis recorded 2656 (82%) data versus 2038 (62%) for the remote monitoring technology (p=0.001). The most common errors with the remote technology were software malfunctioning when starting the MAP monitor and malfunctioning between the tablet and Bluetooth monitor. No serious adverse events were noted. SUS score was 85 (68-93) for 26 patients.ConclusionThis work evaluates the ability of a pilot system to monitor remote physiological data using digital technology after ambulatory surgery and highlights the digital limitations of this technology. Technological improvement is needed in order to reduce malfunction (4G access, transmission between apps).Trial registration: ClinicalTrials.gov (NCT03464721)(March 8, 2018)