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Engineering and Physical Sciences Research Council

New iPad-based 'early warning' system for hospital patient monitoring

Handwritten medical observation charts could become a thing of the past in hospitals with the development of a pioneering patient monitoring system developed in Oxford hospitals. An iPad-based early-warning system developed with EPSRC funding is one of the projects funded by the 'Safer Hospitals, Safer Wards' 260 million NHS Technology Fund to improve patient safety. The 1.1 million funding will allow the team of biomedical engineers and clinicians from the University of Oxford and the Oxford University Hospitals (OUH) NHS Trust to roll out the system across all adult wards in the Trust's acute hospitals.

The new approach uses the latest computer tablet technology both to record and to evaluate patients' vital signs. It will help alert medical staff to patient deterioration on the wards more reliably.

You can find out more about the research in an audio slideshow below: https://www.youtube.com/watch?v=V8R4xVeOK9Y .

The Research Councils UK Digital Economy Programme, which is led by the Engineering and Physical Sciences Research Council (EPSRC), funded the research underpinning this unique 'track-and-trigger' system; its translation onto the ward was supported by the Oxford Biomedical Research Centre (BRC), which brings together university academics with clinicians at the Oxford University Hospitals (OUH) NHS Trust.

Just as now, nurses will regularly take readings of a patient's vital signs such as heart rate and blood pressure. But instead of writing the information on an observation chart, they will input it into an iPad or computer tablet. An Early Warning Score will then be calculated automatically and displayed instantly. The nurse will use this score to help decide whether medical intervention is needed.

Researchers in the University of Oxford's Institute of Biomedical Engineering (IBME) and clinical staff from the OUH Trust, in particular Intensive Care Medicine specialists Drs Peter Watkinson and Tim Bonnici, have worked in close collaboration to develop the system. The EPSRC-funded Centre for Doctoral Training at the IBME is also enabling the study of the clinical impact of the new system at first hand across a variety of wards.

"The new system will help nurses, who work in busy, high-pressure environments, care for patients more efficiently and effectively," says Professor Lionel Tarassenko, Professor of Electrical Engineering, who leads the project.

"The traditional chart-based method of recording vital-sign data is susceptible to errors in both recording and analysis of vital signs. This has been shown in multiple studies, including one funded by the Oxford BRC. Furthermore it limits the availability of the data to the bedside, making its sharing across the hospital difficult.

"The new electronic system automatically calculates the hospital's Early Warning Score, a scoring system which we have developed from extensive statistical studies of patient data. This highlights combinations of vital-sign readings which give cause for concern. The system also enables all vital-sign data and scores to be accessed instantly by all relevant healthcare staff, wherever in the hospital they may be."

In the future, it is planned to take advantage of next-generation scores tailored to different patient groups, for example those recovering from surgery.

At present, six vital signs are measured to calculate the Early Warning Score: heart rate, respiratory rate, blood pressure, arterial oxygen saturation ('the sats'), temperature and level of consciousness. Details of oxygen therapy and clinical concerns can also be recorded on the iPad at the same time. The system has been designed with the future in mind so that it can easily be extended to include other data, such as blood sugar levels or neurological observations.

"The system is currently being rolled out across three wards and then, with the help of the 'Safer Hospitals, Safer Wards' funding, across the whole of the Oxford University Hospitals Trust next year," says Professor Tarassenko. "We see the new system as a major step towards the 'digital hospital' in which all sources of patient information are interlinked and all healthcare staff are interconnected. This can only have a positive impact on patient safety."


Notes for Editors

For more information, contact:

Professor Lionel Tarassenko, Tel: 01865 617675, e-mail: lionel.tarassenko@eng.ox.ac.uk

Images are available from the EPSRC Press Office. Contact: the EPSRC Press Office on 01793 444404 or e-mail: pressoffice@epsrc.ac.uk

Oxford University Hospitals NHS Trust Press Office Tel: 01865 231471, e-mail: media.office@ouh.nhs.uk


The Engineering and Physical Sciences Research Council (EPSRC) is the UK's main agency for funding research in engineering and the physical sciences. EPSRC invests around 800 million a year in research and postgraduate training, to help the nation handle the next generation of technological change. The areas covered range from information technology to structural engineering, and mathematics to materials science. This research forms the basis for future economic development in the UK and improvements for everyone's health, lifestyle and culture. EPSRC works alongside other Research Councils with responsibility for other areas of research. The Research Councils work collectively on issues of common concern via Research Councils UK. http://www.epsrc.ac.uk

RCUK Digital Economy Theme

The Research Councils UK (RCUK) Digital Economy Theme is supporting research to understand how the novel design and use of digital technologies can contribute to a innovative, healthy economy and inclusive society.

The IBME at the University of Oxford is sponsored by the EPSRC, the Medical Research Council, the Department of Health, the Wellcome Trust and the Oxford Biomedical Research Centre. The IBME was awarded an EPSRC-funded Centre for Doctoral Training in 2009. Focused on healthcare innovation, this centre for 'Biomedical Engineering at the Translational Interface of Next Generation Healthcare' is training up to 100 students as part of its four-year programme.

The Oxford Biomedical Research Centre, one of 23 research centres operated by the NHS' National Institute for Health Research (http://www.nihr.ac.uk), is a collaboration between Oxford University Hospitals NHS Trust and Oxford University to accelerate the translation of basic science and healthcare innovation into practice.

The Oxford University Hospitals NHS Trust (OUH) is one of the largest acute teaching trusts in the UK, with a national and international reputation for the excellence of its services and its role in patient care, teaching and research. The Trust supports world-leading research programmes, employs 11,000 staff and consists of four hospitals: the Churchill Hospital, John Radcliffe Hospital and Nuffield Orthopaedic Centre in Oxford and the Horton General Hospital in Banbury. http://www.ouh.nhs.uk

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