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National postoperative virtual care study

In light of the COVID-19 pandemic, it’s more important than ever to investigate remote automated monitoring (RAM) of patients. PJ Devereaux, Senior Scientist at PHRI, notes that “when COVID-19 restrictions came into effect in early March, hospitals were challenged to drastically reduce non-emergency care.

Taking vital signs is an important part of care in hospital, so it stands to reason that taking patients’ vital signs virtually from home makes a lot of sense, especially in patients who are at high risk for complications.”

Devereaux and co-PI, Mike McGillion, launched the PVC-RAM study to address this issue.

The trial is recruiting 900 adults across Canada who have undergone semi-urgent cancer surgeries, urgent surgeries such as hip fractures, or emergency surgeries such as a ruptured abdominal aortic aneurysm. Patients receive technology, from Cloud DX  – tablet and remote monitoring equipment to assess heart rate, blood pressure, temperature, respiratory rate, oxygen saturation, and weight. – to use at home after discharge from hospital.

For the following 30 days, they will take their own vital signs and fill in daily surveys, then conveyed wirelessly to nursing stations at Ontario hospitals in Hamilton, London, Kingston, Ottawa, as well as in Winnipeg, Manitoba, and Edmonton, Alberta. Nurses will assess the data and have secure video “visits” with the patients.

Trial participants who are not randomized to receive virtual nursing station care receive the current standard care which is at the discretion of the surgeon. Typically, this care includes an in-person clinic visit in two to eight weeks after discharge from the hospital.

Mike McGillion notes that “we can increase our capacity to do more elective and urgent surgeries, if we can reduce the volume of hospital admissions. Especially since patients transition home sooner after surgery, globally remote patient monitoring is going to be the way of the future.” (He and PJ Devereaux are co-editors, with the American Journal of Medicine, American Journal of Cardiology, and Canadian Journal of Cardiology, of Reducing Global Perioperative Risk resource center.)

Seed funding for the PVC-RAM trial was received through Roche Canada’s COVID-19 Open Innovation Challenge.