AvaSure: Using Video Monitoring to Improve Patient Safety and Achieve Cost Efficiencies

In this business profile, Brad W. Playford, founder and CEO of AvaSure, discusses the value and benefits of virtual patient monitoring.

Tell us a little bit about your organization.

In 2009, AvaSure was an integrated business security solutions company based in Grand Rapids, Mich. That year, we found our future, launching the AvaSys TeleSitter Solution—a virtual patient engagement solution that allows remote monitoring of 12 or more patients on one large screen and the ability to intervene instantly via audio to prevent harm. Monitored patients have been deemed by the healthcare institution to be at risk of hurting themselves or others, and they therefore require continuous observation. The fixed and mobile versions of our room units are now found in hundreds of hospitals across the United States and around the world. As the company has grown, we’ve added a dedicated team of registered nurses who continue to refine a clinical education program that accompanies the technology, bringing patient monitoring and communication best practices to the field. Most recently, we began offering comparative data on utilization and outcomes.

What are the challenges your system addresses?

Within the acute care setting, there are many patients at risk of hurting themselves or others. These individuals may have an increased likelihood of falling, eloping, becoming violent, and so on. To prevent an adverse event, hospitals must closely monitor these high-risk patients. Typically, this means putting a trained staff person—a sitter—in the room 24/7. Although that approach is often ineffective in reducing risk, most hospitals are spending at least seven figures annually on sitters.

On the other hand, insufficient patient monitoring can result in costly problems. If an individual falls, for example, there are often serious injuries that require medical treatment, and, in some cases, there might be significant medical malpractice litigation exposure.

By using our continuous monitoring service, hospitals and health systems can keep an eye on multiple high-risk patients at the same time. Not only does this cut the costs of treating these patients, but our solution catches and prevents adverse events, helping organizations increase safety and quality as well.

How does your solution work?

There are three major components to the AvaSys solution: technology, clinical workflow, and data analytics.

From a technology standpoint, our system aggregates tele-sitter views of at-risk patients. A mobile or fixed device in the patient’s room sends images over the regular hospital network to a 40-inch video screen in a centralized location where a trained observer monitors multiple patients simultaneously—sometimes as many as 15 individuals. There are shifts of observers, so patients are continuously watched. A camera on each cart has pan, tilt, and zoom capability, allowing the observer to see anywhere in the room, including fine details, such as skin color changes, shallow breathing, and whether a patient’s pulse oximeter is still attached.

Through two-way audio, the observer vocally engages with the patient, and the patient can respond without having to touch anything. If the patient tries to do something he or she shouldn’t—like get out of bed on his or her own—the observer can intervene by saying, “Mrs. Smith, what are you doing?” or, “Hold it right there, I’m going to get somebody to help you.” If the patient is unresponsive to verbal direction, there is a STAT alarm that automatically cues the nursing staff to immediately go to the patient’s room.

When there is a language barrier, staff can use the solution’s pre-recorded statements that come in more than 200 languages. These include common phrases such as, “Stay in bed,” or, “I’m going to get your caregiver right away.”

In terms of clinical workflow, we make sure the hospital has the appropriate protocols in place to support the technology. Before implementing the solution, our clinical team determines how the hospital currently responds to these types of patients. The team then works with the hospital to create policies, procedures, and protocols that ensure reliable identification of patients who require watching, consistent patient-monitoring criteria, comprehensive observer job descriptions, accurate data collection, and so on.

We also provide robust monitor technician training. During implementation, we have clinicians on site to credential these staff. After go-live, we check in every 30 days. In those cases where a replacement observer is hired, hospitals can use our e-learning tool to get the individual up to speed. We also offer continuing education with courses related to geriatric sensitivity, verbal de-escalation, and how to respond to a patient who is at risk of self-harm.

Finally, we provide strong data analytics. The system includes a real-time dashboard that shows a variety of metrics, including, but not limited to, the current number of carts in use, verbal redirections, STAT alarms, and so on. In addition, we deliver a broader set of metrics that can drive performance improvement. Leaders can view comparative data by observer, unit, shift, patient condition, and so forth, analyzing how their staff and processes compare with similar organizations.

What advice would you offer to healthcare leaders when choosing among vendors?

Look for a company that has a wealth of experience. Virtual patient monitoring requires up-to-date technology and solid clinical support. You want a vendor that is an expert in all aspects of the process—and you want one that has a track record of partnering with the best. AvaSys is now deployed in half of U.S. News and World Report’s Honor Roll of the 20 best hospitals, including the top three.

You also want to select a vendor that can demonstrate financial results. For example, our clients can expect that for every $1 million spent on our system, they will see a return of $2 million to $4 million every year. We consider a variety of cost savings in calculating this ROI. First, there is the savings that comes from not having to hire sitters to watch patients. There is also the money saved in preventing negative events, such as falls or elopement, which can cause injury. Also, with our system, you can avoid litigation and CMS penalties for never events.

As healthcare organizations implement use of AvaSys into their day-to-day operations, what advice would you offer so they can best set themselves up for success?

Strong program leadership is key. Moving to this kind of system can be a bit disruptive because it is a departure from the typical approach. So, you need to have leaders whom people respect, believe in, and will follow, and these individuals must take responsibility for building enthusiasm and maintaining momentum. Once the decision is made to get this technology, leaders must be committed to getting the most out of it and stay involved in the work to ensure long-term success.

Are there any educational materials you would like to share to help healthcare providers in these efforts?

For more information about the AvaSys Telesitter Solution, go to our website at http://avasure.com. Upon request, we can provide a wealth of peer-reviewed research on our results.

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