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Along with Better Patient Care, Dividends Can Accrue with Purchase of Central Monitoring System
- Eduardo Miranda, BSEE, M.Sc.
The decision to purchase equipment for your clinic or practice is often a multi-faceted analysis of both the potential benefits to patient care and whether there is a true need that brings an actual return on the investment (ROI). When multiple specialty areas within a clinic can benefit from the equipment, the procurement can be even more attractive.
Central Monitoring Systems
When it comes to ROI, central telemetry and monitoring systems check off a lot of boxes – especially amidst an animal health environment rife with overworked veterinarians and technician staff shortages resulting from COVID impacts. In addition to the immediate fiscal efficiencies they can provide in relation to staffing, logistics and time resources, the ability of these systems to increase the quality of patient care can build pet owner confidence that fortifies your client business base for the future.
Central monitoring systems allow veterinary staff to monitor the conditions of multiple emergent, critical and surgical patients – across specialties – in real-time via multiple connected devices, automatically syncing with these devices. These systems often allow viewing of numerical values, waveforms, active alarms and in some cases, support bi-directional communication with connected monitoring devices – allowing for quick mitigation of declining patient health situations while saving time for veterinarians and providing needed monitoring and support resources that can fill the gap in support staff.
In addition to viewing patient vitals (temperature, ECG, SpO₂, NIBP, EtCO₂, etc.) across multiple monitoring devices, some systems also do some heavy lifting with patient management including patient admission and discharge handled directly from the system. Others also include software that allows for generation and printing of Excel and PDF reports of tabular data including ECG recordings of significant time blocks of cardiac activity.
Despite the financial benefits, veterinarians who elect to purchase a central station for managing their monitored patients will cite several reasons for adding the equipment with the capability of enhancing patient care ranking high in the decision.
Increased response for better care
“Our primary reason for purchasing a central station for managing monitored patients was to improve the quality of our patient care,” says Marcos Unis, DVM, MS, DACVS-SA, of Access Specialty Animal Hospitals in Royal Palm Beach, Florida. “I feel it has improved our anesthetic monitoring capabilities significantly. By allowing simultaneous patient monitoring, we can detect problems and dispatch the critical doctor or anesthesiologist to help.”
With remote viewing and access, having a central monitoring system on the premises certainly affords logistical convenience that expedites response time. Increased situational awareness can come from having a central monitoring system that is linked with anesthesia gas monitoring and invasive blood pressure systems, increasing response time for patients in the intensive care unit (ICU), emergency department and operating room (OR).
“Central monitoring can be instrumental in improving patient outcomes by allowing doctors to monitor patients from their desks or anywhere in a hospital. Without this type of system, we would need to be in the OR monitoring individual monitors,” says Unis. “We have multiple cases being monitored simultaneously and it also allows our anesthesiologist the ability to monitor several patients simultaneously so she can provide the highest level of care.”
Added support extends depth of team
When investing in a central monitoring system, the goal is to find the best option in veterinary monitoring equipment as well as equipment support that can extend your budget. While much of veterinary monitoring equipment offerings on the market share many of the technologies within, such as specifically-branded ETCo2, NIBP and SpO₂ monitoring, some manufacturers offer proprietary functions that feature more user-friendly, advanced platforms for the veterinary anesthesiologist, anesthetist, criticalist or critical care technician across nearly all specialties.
Besides the equipment itself, some veterinarians are seeking, and thriving, from biomedical support that accompanies the purchase of their central monitoring system – including individualized clinical support from the manufacturers support team members that maximize the advantages of their equipment purchase.
Alexander Dehne, LVT, RVT, VCC, of VCA Veterinary Care Animal Hospital and Referral Center, a 24-hour, multi-disciplinary specialty hospital in Albuquerque, New Mexico, says his facility has integrated a central monitoring system as a member of its critical care team after enduring an ongoing problem with staff shortages.
“As a veterinary hybrid hospital, our 18 DVMs see some of the sickest patients from a 350-mile radius. Our inpatient caseload can vary from 12 to 21 inpatients at any time, with up to five critical patients,” says Dehne. “If you look at any of the job boards for veterinary support staff in the U.S., you’ll see that there is a dramatic shortage in veterinary technicians. We are affected greatly by this shortage, so the addition of a central monitoring and technical staff productivity. We have implemented well-monitored protocols to utilize digital monitoring for ALL transfusion patients. With a simple taped-in rectal temperature probe and atraumatic ECG clips, we have decreased the stress."
Dehne uses a wireless HDMI connector to project his clinic’s central monitor system throughout key areas of his hospital. He reports that having it in several locations within the building has increased transparency and patient awareness in the facility and created a greater level of patient care.
Ways central monitoring impacts ROI
There are direct and indirect avenues from which clinics can extract revenue with the addition of a central monitoring system. Immediately, a clinic can realize efficiencies that allow veterinarians to see more patients in less time, as well as avoid non-productive down time due to staff shortages by using the system as an extension of the clinic’s staff. Directly billing clients for advanced monitoring can also be a profit center that can be quickly implemented.
“All of our patients that are deemed high risk or unstable are fitted with either temperature, ECG, SpO₂, NIBP or EtCO₂ monitoring, so utilizing central monitoring as a part of the team with any patient that is deemed either unstable or high-risk, has greatly increased our capacity for care and the number of patients that may be seen at any given time,” says Dehne.
“Furthermore,” adds Dehne, “I will always fight to have a central monitoring system within my hospital. The manufacturer of the system we currently use is an extension of the hospital – their support team has always been right there when we need them and offer us the best technology possible for our patients. On top of that, charges can be assessed in 12-hour increments for advanced monitoring with the cost broken down based on the level in which the patient is monitored within the ICU. SpO₂ and NIBP are add-ons to our current base ECG monitoring fees. Typically, continuous temperature and heart rate monitoring for patients undergoing blood transfusions are monitoring parameters that are not charged due to the simple nature of the transfusion monitoring fee and blood transfusion set-up cost.”
“I believe using a central monitoring system has made us more profitable by improving our efficiency and quality of patient care,” says Unis.
Over time, the confidence built among your client base can result in additional, indirect financial gains in the form of repeat business due to that confidence in your professional care and technological capabilities – something to consider as you forecast your practice’s 2022 capital expenditures.
Eduardo Miranda, BSEE, M.Sc. is a biomedical engineer and president of Digicare Animal Health, a manufacture of veterinary-specific multiparameter monitoring systems, telemetry and central monitoring systems.
Two images - courtesy of Digicare Animal Health - accompany the article above. Corresponding image captions are included as follows:
Image #1 – Time and resources are saved when veterinarians can view multiple patients anywhere in the clinic or remotely.
Image #2 – Central monitoring systems allow clinics to remain efficient in the face of staffing shortages.