Department of Biostatistics, Epidemiology, Public Health and and Methodological innovation (BESPIM), Nîmes University Hospital, University Montpellier 1, Montpellier, France.
Staff anesthesiologists, Department of Anesthesiology and Pain Management, Centre Hospitalo-Universitaire (CHU) Carémeau, Place du Professeur Debré, Nîmes, and Montpellier University 1, Montpellier, France.
BMC Anesthesiol. 2020 Oct 8;20(1):259. doi: 10.1186/s12871-020-01178-5.
Remote monitoring of mean arterial blood pressure (MAP), heart rate (HR) or oxygen saturation (SpO) remains a challenge in outpatient surgery. This study evaluates a new digital technology (Smart Angel™) 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.
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 SpO, 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 Angel™ 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.
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.
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).
ClinicalTrials.gov ( NCT03464721 ) (March 8, 2018).
远程监测平均动脉血压（MAP）、心率（HR）或血氧饱和度（SpO ）仍然是门诊手术中的一个挑战。本研究评估了一种新的数字技术（Smart Angel™），用于实时远程监测血流动力学数据：将患者家中的数据传输到中央服务器，使用专用的基于网络的软件包。
前瞻性纳入计划接受择期门诊手术的成年人。在术后的前 5 天，患者通过连接到 4G 平板电脑的两个无线蓝牙监测器完成自我报告问卷（疼痛、舒适度、恶心、呕吐）并记录 SpO、HR 和 MAP，并使用 Smart Angel™软件实时将数据传输到网站。在传输到网站之前，患者还会在纸质表格上自行报告这些数据。主要结局是通过该系统传输到医院的变量（自我监测生理数据+问卷评分）与纸质版本相比的比例。在第 5 天，还对系统可用性量表调查（SUS 评分 1-100）进行了赋值。
2018 年 5 月至 2018 年 9 月，30 名入组患者中，有 29 名（1 名患者术后未出院）的数据可用。远程监测技术记录了 2038 个数据项（占 62%），而纸质表格记录了 2656 个（占 82%）数据项（p=0.001）。远程技术最常见的错误是 MAP 监测器启动时软件故障和平板电脑与蓝牙监测器之间的故障。未发生严重不良事件。对于 26 名患者，系统的 SUS 评分为 85（68-93）。
本研究评估了使用数字技术在门诊手术后监测远程生理数据的试验系统的能力，并强调了该技术的数字局限性。需要改进技术以减少故障（4G 接入、应用程序之间的传输）。
ClinicalTrials.gov（NCT03464721）（2018 年 3 月 8 日）。
