Abstract 11949: Mobile Technology-Based Home Monitoring for Infants With Single Ventricle

Babies born with a single ventricle typically require 3 heart operations, the first of which is performed prior to discharge. These babies are prone to mortality and morbidity between stages of surgery. Over the past decade, attempts have been made to improve outcomes by instructing family members in the use of weight scales and pulse oximeters. However, this system imposes the stresses of recording, calculation and surveillance, and may not result in timely interventions. Methods: We have developed a platform that uses a tablet PC (Microsoft Surface), a Bluetooth pulse oximeter (oxygen saturation and heart rate, Nonin) and custom software that provides for manual entry of weight, intake and output data as well as recording of high-definition (HD) video of the baby. The HD video recordings are transmitted with embedded audio, which is used to monitor the baby’s breathing pattern. A reminder feature is built into the system. All data is time-stamped and encrypted within the tablet and is transmitted to an enterprise database using a secure wireless connection. Algorithms within the database send varying levels of alerts (scheduled summary daily emails or instant pages, as appropriate) to the care team based on customizable thresholds. Each of the quantitative parameters that are transmitted can be viewed graphically. The video recordings can be viewed remotely. All database entries are transmitted to the electronic medical record. Results: The system is in clinical use by 8 families to monitor their children. It has triggered 5 readmissions and 10 changes in management. All interventions were appropriate; there have not been any false positives. Conclusions: This platform provides a promising method to integrate home monitoring data into the near-instantaneous monitoring of babies with single ventricle (a high-risk group). Evaluation of the effects of this platform on the timeliness of interventions, the incidence of interstage mortality and morbidity and parental stress, are ongoing.