The Monitoring Messenger: Mobile Patient Monitoring for the Pediatric Intensive Care Unit

The Mobile Messenger is a unified, portable and intelligent device that integrates information from multiple patient monitors, mechanical ventilators, infusion pumps and clinical information systems on a mobile platform. It will allow nurses, respiratory therapists and physicians to continuously monitor and coordinate care of critically ill patients. This study will use a participatory design process to guide the design of an integrated mobile device. Next, we will evaluate the proposed device in a simulated ICU setting.

Study Overview

• Status: Withdrawn
• Conditions: Critical Care; Medical Device; User-Computer Interface; Physiologic Monitoring
• Intervention / Treatment: Device: Monitoring Messenger; Device: Traditional tools

Detailed Description

There are a limited number of nurses, respiratory therapists and physicians in an ICU at a given time. To make decisions and plan therapies, these clinicians need to observe, assimilate and interpret a vast array of information originating from various devices located on the bedsides of multiple patients. Several shortcomings in existing technology limit their abilities: a) the fixed location of monitoring devices at the bedside; b) information overload from a multitude of devices, each with its own display; c) the lack of integration and interaction between these devices; d) the use of visually cumbersome displays, which were historically created for monitoring during anesthesia but never optimized for users in the ICU; and e) lack of context specific information (such as historical trends) to support patient data interpretation and clinical decision making.

This project proposes to address these challenges in ICU monitoring by developing a unified, portable, and intelligent device: the Monitoring Messenger. By integrating information from multiple monitoring devices, mechanical ventilators, infusion pumps and clinical information systems on a mobile device (tablet PC or smart phone); the Monitoring Messenger will allow nurses, respiratory therapists and physicians on or off-site, to continuously monitor critically ill patients, thereby increasing patient safety.

The proposed experiment will have two parts: Part I - Participatory design and Part II - Simulation Experiment.

In Part I - Participatory Design. Participatory design an inter-professional team of nurses, physicians, designers, engineers, and human factors experts will follow a user-centered design process to obtain the system requirements, and obtain feedback during the rapid prototyping phase of prototype development. While we expect the resulting prototype to be easy to use, support decision making, improve awareness of the patient's condition by health care providers and reduce mental workload, this methodology is not hypothesis driven.

Part II - Simulation Experiment. In simulated ICU scenarios, the critical care physicians, nurses, and respiratory therapists will prioritize the care of critically ill patients. We expect them to do so more accurately with the use of Monitoring Messenger than with their regular tool (monitors, paper records etc). A potential outcome would be a decrease in mental workload as well as an increase in situational awareness.

• Study Type: Interventional
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V6H 3V4
      • BC Children's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Staff pediatric critical care physicians, pediatric critical care fellow physicians, registered pediatric nurses and respiratory therapists will be eligible to participate in this study
• Subjects willing to provide informed consent

Exclusion Criteria:

• Inability/failure to provide informed consent.
• Nursing students and resident physicians are not eligible
• For Part II - Simulation Experiment only: Failure to complete the post-training quiz more than twice.
• Evaluation will be immediately discontinued at request of subject at any point during the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Monitoring Messenger	Device: Monitoring Messenger; Monitoring Messenger prototype device
Active Comparator: Control; Traditional tools (monitors, paper records)	Device: Traditional tools; Paper based records, screenshots of monitors and therapy devices

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Accuracy of priority assignment in triaging task	Accuracy will be measured by matching of the participants triage priority ranking with the previously defined expert ranking.	Up to 1 hour

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Requirements for design of the mobile device	Information requirements for tasks, task frequencies, perceived challenges and potential suggestions to improve their current work environment using a mobile monitoring and messaging device	Up to 2 hours

Collaborators and Investigators

• Sponsor: University of British Columbia
• Investigators: Principal Investigator: Mark Ansermino, MBBCh, FRCPC, The University of British Columbia

Publications and helpful links

Helpful Links

• Pediatric Anesthesia Research Team website
• Electrical & Computer Engineering in Medicine (ECEM) website

Study record dates

Study Major Dates

• Study Start: November 1, 2013
• Primary Completion (Anticipated): January 1, 2017
• Study Completion (Anticipated): January 1, 2017

Study Registration Dates

• First Submitted: June 1, 2012
• First Submitted That Met QC Criteria: June 4, 2012
• First Posted (Estimate): June 5, 2012

Study Record Updates

• Last Update Posted (Actual): October 26, 2017
• Last Update Submitted That Met QC Criteria: October 24, 2017
• Last Verified: October 1, 2017

More Information

Terms related to this study

• Keywords: Telemedicine; Intensive Care; Expert System; Equipment Design
• Other Study ID Numbers: H12-01270