The integration of cloud computing, wireless sensor technology, and IoT in a healthcare environment along with the use of wireless sensor technology is emerging as a significant element of next-generation patient monitoring services in real time.

The digital technology revolution in healthcare has changed the way the hospitals connect and communicate. The patient monitoring equipment forming an indispensible part of medical team for every procedure, whether operating in a small clinic or a large multi-specialty hospital, network connectivity has become essential to administer healthcare in the modern era.

Technology Trends

Clinicians are facing challenges on all fronts and rising patient acuity requires patient monitoring and therapy equipment that connect and capture data with zero compromise to patient care. Data from these connected monitors is sent to the hospital's electronic medical record (EMR) systems in high-acuity settings like the OR and the ICU or in low-acuity settings like medical-surgical units. When data from different monitors are more readily available in the patient's electronic medical record, they may provide a clearer and more complete picture of the patient.

Advances in data integration. Data integration is the opportunity to build a more holistic representation for every patient. Integration of all monitored variables together with the patient's history and laboratory tests coming from electronic medical record (EMR) systems opens the doors to the development of smart systems (artificial intelligence) able to suggest a diagnosis or a treatment, and even to deliver therapy. Connectivity and data integration may allow the development of controllers able to process multiple parameters at the same time and guide or unload clinicians in more complex clinical situations.

Need for predictive analytics. The simplification of monitoring systems - becoming smaller, smarter and even wireless - is boosting the clinical applicability of predictive analytics. The combination of several parameters, usually vital signs, and the automatic recognition of specific patterns allow the detection of adverse events earlier than the classical side-by-side monitoring of single parameters. Predictive analytics may be useful to trigger the intervention of a rapid-response team (RRT) and accelerate ICU admission for patients in the ward or the emergency department or to postpone ICU discharge for patients who are about to leave the unit.

Metabolic monitoring. Technical advances in measurement of gas exchange in ICUs have enabled the use of metabolic monitors for estimation of energy expenditure, assessment of pulmonary physiology, oxygen utilization, success of weaning, and measurement of metabolic stress. The evolution of metabolic sensors has made in-situ measurements of blood gases and electrolytes possible in patients with an arterial catheter or a central venous catheter. They allow on-demand measurements and quick results without any blood loss. Besides their ability to record and transmit vital signs, these sensors have the potential to measure electrolytes and lactates in skin fluids. They may further bring opportunities such as remote metabolic monitoring in patients with chronic diseases once their reliability is established.

Multiparameter monitoring system. A system is designed based on programmable logic controller (PLC), which helps to record and analyze the multiple parameters of patients from their homes. The monitoring system consists of several sensors such as temperature sensor for body temperature measurement and pulse oximeter to find the oxygen saturation and hemoglobin of a person. A pair of EPIC sensors with differential amplifier is used to measure the electrical activity of a patient's heart. Methodology of this system is the analog output of each sensor, which is connected to the patient, is directly given to where it stores in the memory of the controller, and from PLC through serial port it is transferred to a personal computer. This system monitors the human health condition through SCADA system. The research project is undergoing in the Department of Electronics & Communication Engineering, CIT, Gubbi, Karnataka, India.

Opportunities

The Telehealth Initiative under Digital India program is a major step taken by the government of India for deeper digital penetration in rural areas. The government has taken up BharatNet in mission mode to connect all 250,000 gram panchayats in the country. This would open up new avenues for patient monitoring equipment manufacturers and suppliers for providing remote monitoring to these patients. Also the multiparameter patient monitoring equipment will get a great boost with the telemedicine initiative as it will become easier to transfer vital signs data in the EMR of the patients living in remote areas.

Way Forward

The way forward is a truly connected system that provides information from wherever a patient may be to a clinician, wherever the clinician may be. It would consist of a standalone device portion that continuously monitors all five vital signs - blood pressure, blood oxygen saturation, skin temperature, respiration, and heart-pulse rates - using a thumb and chest sensor. The measurements would be displayed on a device resembling a big watch that is worn on the wrist. Via the next-generation Wi-Fi wireless technology, the vital signs data would be transmitted across a hospital network to a workstation or a tablet.

Dr Vivek Gupta, HOD, Anaesthesiology, Saroj Super Speciality Hospital, Delhi
Second Opinion
Aging Population Drives the Market

Patient monitoring devices help clinicians to detect abnormal physiology, which changes rapidly to changing situation of patient's physiological condition. Continuous monitoring helps clinicians reduce the lag time in identifying a changing state of patient and acting appropriately. These monitoring devices are used in hospitals, homes, and ambulatory setups. Patient monitoring equipment plays a crucial role in the hospital such as emergency rooms, intensive care, and critical care units. Patient monitoring devices include wide range of equipment such as multi-parameter patient monitors, patient monitoring accessories, non-invasive blood pressure monitors, fetal and neonatal monitors, and remote patient monitoring (RPM) and micro-electromechanical systems.

Technological Trends

Technology innovations have provided advanced and sophisticated multi-parameter patient monitoring systems that have replaced the traditional single-parameter patient monitoring systems. Advances in RPM technologies have resulted in reduced healthcare costs that are associated with frequent hospitalization and re-admissions and improved patient recovery and encouraged a faster response rate in certain casualty cases. Advancement in monitoring has played a major role in conduct of safe anesthesia leading to advancement of surgery and recovery in ICU. Minimum monitoring standards are incorporated in guidelines by various medical associations.

Current Market Dynamics

India is one of the primary markets for patient monitoring devices and is expected to reach USD 702 billion this year. The country's elderly population accounts for a large percentage of the population suffering from chronic diseases, leading to increased hospitalizations, and is expected to drive the future growth of the market. Remote patient monitoring (RPM) will continue to be the fastest-growing segment.

Technological innovations and the increased adoption of products with advanced patient monitoring technologies are further expected to raise the growth of the patient monitoring devices market in the future. The market is primarily driven by the aging population worldwide. The aging population in turn increases the hospitalization rate, which increases the demand for patient monitoring devices. Increasing investment on healthcare infrastructure in emerging economies by corporate groups provides significant opportunity for future growth of the patient monitoring devices market.

Dr Vivek Gupta
HOD, Anaesthesiology,
Saroj Super Speciality Hospital, Delhi


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