Researchers at the McMaster School of Nursing at the Population Health Research Institute (PHRI) wanted to improve the health outcomes for seniors recovering at home from cardiac and vascular surgeries (CaVS). The research team asked MEDIC to consult on the technical feasibility, integration, and interoperability of the health eco-system for a seamless end-to-end patient and provider experience.
Research Area: MEDIC
Project Funder: Canadian Institutes of Health Research (CIHR)
Future Ready Challenge
Tens of thousands of cardiac and vascular surgeries (CaVS) surgeries are performed on Canadian seniors each year. Following surgery, it is standard practice for healthcare teams to monitor patients to identify potential problems but, due to staffing constraints, most postsurgical wards only complete in-person vital signs checks every four to 12 hours. It’s also not uncommon for patients to be sent home without any remote monitoring or healthcare support. This limited monitoring results in thousands of cases of undetected or late-detected blood flow problems, which in turn can lead to severe complications, reduced quality of life and high rates of readmission to hospital.
Studies have shown that the continuous automatic and remote monitoring of vital signs significantly reduces these risks and can also help surgery patients leave the hospital sooner. However, the healthcare IT environment is very fragmented, due to strong operational need for a wide range of applications and platforms. In order for hospitals to implement successful remote monitoring, it’s important that multiple vendors’ systems seamlessly work together. In addition, the systems needed to work together both in the hospital and the home environments.
R & D Collaboration
The research team established the SMArTVIEW research project to understand how remote automated monitoring and connected care could impact important recovery outcomes such as postoperative complications and recovery experience for cardiac patients.
MEDIC played a role in early conceptualization of the SMArTVIEW study. MEDIC faculty advised SMArTVIEW Principal Investigator, Michael McGillion, and participated in mapping out the intervention workflows, as well as the approach to take to engage industry partners. “It was the MEDIC team who mentored me to work with industry in this unique way” says McGillion.
Before beginning the research study, the team needed to ensure that their recommended monitoring systems could be used for post-op care both at the hospital and at home. The PHRI team asked MEDIC to consult on the interoperability of the different systems for a seamless end-to-end operation.
Innovative Results
MEDIC identified the technical constraints and collaborated with stakeholders to architect a highly integrated interoperable system of systems (SOS), connecting the multiple decentralized subsystems required to provide the end-to-end solution needed by the research team.
The MEDIC team worked with the HHS Health Information Technology Service and research group to enable two different digital health systems to communicate and work together by identifying critical interfacing requirements and bridging the gaps between the two systems. The team broke down one system’s messaging format into its basic components, then mapped the components to a second system’s messaging format. This fundamental mapping allowed the MEDIC team to build an integration engine that could connect the two systems automatically, making data exchange fast, efficient and intelligent
With communication between subsystems established, the research team completed user testing in 2018 and in the same year launched the SMArTVIEW clinical trial.
“SMArTVIEW was suspended during the first wave of the pandemic in 2020, but we are pleased to say that this important trial in virtual and remote post-surgical care is back up and running”, says McGillion. “We wish to thank MEDIC for its important role in making SMArTVIEW happen”.