Implementation of a Tiered Cardiac Telemetry System: An Operational Blueprint at Mayo Clinic

Abstract

Objective: To investigate the operational outcomes and implementation effects of tiered cardiac telemetry monitoring in a hospital environment using an innovative technology. Patients and Methods: The research focuses on assessing the precision, speed, and reliability of alerts generated by a wireless device in adult patients aged 18 and above, concurrently monitored by a hardwired, continuous cardiac monitor. Using an agile methodology, we tested and validated a nonhardwired, cellular-connected continuous cardiac monitor (InfoBionic MoMe) in 162 patients. A comparison was made between the wireless device and the standard hardwired system, conducted at Mayo Clinic Hospital with Institutional Review Board approval from June 6, 2022, to December 15, 2022. Results: The study revealed a high correlation of events captured compared with the standard care model. Differences in algorithms, alarm parameters, and operational considerations impacting clinical implementation were observed. Connectivity improvements during the study reduced latency from 3-5 minutes to 30 seconds. Delayed alarms were attributed to device damage (4.5% of cases) and poor cellular connections (29% within 31-60 seconds). Conclusion: The implementation of tiered cardiac telemetry in hospital environments, coupled with advancements in remote cardiac monitoring, supports expanded bedside telemetry capabilities and near real-time remote monitoring postdischarge. Although the study successfully validated the wireless device concept, improvements are needed before implementation for inpatient cardiac monitoring. Further research and technological enhancements can build on these findings to enhance health care practices in this domain.