SCL Health launches innovative infant monitoring hub

LAFAYETTE and BRIGHTON — Infant and new mother health outcomes along the Front Range are at the cutting edge of advancements that leverage artificial intelligence applications in medicine thanks in part to the PeriWatch Command Center remote fetal health monitoring system. 

The eight-hospital SCL Health system is an early adopter of the new monitoring system and just approved PeriWatch (a platform created by PeriGen Inc., a Halma company) to go live in September with Good Samaritan Medical Center in Lafayette to come online in April 2022. 

“The biggest improvement and what we’re looking for is we want to reduce the amount of babies born and admitted to the NICU (Neonatal Intensive Care Unit),” said Deb Lowery, RN, administrative director of Women’s and Children’s Services at SCL Health. “This has never been done in OBs quite like what we’re doing. … In a six-month period, we saw improved outcomes in the scoring the baby gets when it’s born.”

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The remote monitoring system links floor nurses in perinatal units at SCL’s hospitals to a centralized monitoring hub, the SCL Health OB Hub in Denver, to receive telemetry from the sensors sending patient data. 

The OB Hub is supervised and run by teams of labor and delivery clinicians that interact with the artificial intelligence sub-system by receiving early advanced warning of infant patient problems that may be developing. Fetal monitoring strips provide real-time 24/7 monitoring of fetal heart rate and maternal vital signs, contractions and labor progression. The strips consist of a special ultrasound device tracking the baby’s heartbeat and pressure sensors measuring uterine contractions — the two devices are embedded into monitoring strips that are strapped around the mother’s belly and connected to a monitoring terminal.

Accurately “reading” a traditional electronic fetal monitoring strip is much more technically challenging than reading something like a cardiogram for muscle activity of the heart, so errors can result when perinatal floor nurses’ time is constrained.

Electronic Fetal Monitoring has been used in perinatal obstetrics since the 1970s, a technology that has seen little change, but the time constraints and demands on perinatal nurses have increased. They must track and document as many as 10 different characteristic patient variables every 15 to 30 minutes, depending on the stage of labor.

“These monitoring patterns that the baby puts out are hard and difficult to read and take lots of expertise,” Lowery said. “If you don’t have the right eyes looking at the strip, you may miss something.”

The OB Hub clinician team uses PeriGen’s automated early warning capabilities to provide remote monitoring while nurses help their patients at each of the hospitals. The early-warning sub-system is designed to provide a first-pass interpretation screening for the monitoring strip data stream coming from many hospitals at once into the OB Hub. The artificial intelligence component leverages its pattern recognition confirmations at high speed, providing an initial layer of protection, coupled with the human layer from the Hub nurses. Those nurses can then open individual charts for a detailed view and conference with and assist the floor nurses in mitigations.

“It’s another layer of safety in the midst of a nursing shortage that I can guarantee babies will arrive in this world safely because we provide an extra experienced eye to watch them,” Lowery said. “The nursing shortage is real. A lot of more experienced nurses are retiring or moving out of nursing. We have more and more shortage of nurses in Colorado and less experienced eyes on fetal monitoring strips.” 

The OB Hub nurses additionally use PeriWatch Vigilance to visually consolidate up to 12 hours of monitoring information at a time on a color-coded dashboard. The nurses and physicians can use this visual to evaluate trends in patient characteristics and the progression of the labor. Vigilance can track hundreds of patients, continuously sorting and color-coding them according to defined parameters and notifying clinicians based on degree and duration of abnormality in the trend of the involved characteristic or characteristics for a given patient.

“It’s much different than what nurses see at the bedside,” Lowery said. “The nurses just see the fetal monitor strip. It doesn’t make suggestions and tell them what to do.”

SCL Health already has seen results from a six-month pilot launched in March of significantly improved fetal scores and decreased admissions to the NICU. The Vigilance coverage will be made available through the hub for an additional 12,000-plus infants and mothers annually.

“This hopefully is another safety measure to get babies safely into the world,” Lowery said. “Nurses come to work to do an excellent job, and I think they get worried when it’s super busy and they aren’t providing the best care possible. This gives them a sense of somebody having their back, somebody helping them with their job.”

The system will be expanded to SCL Health’s three hospitals in Montana by July, St. Mary’s Medical Center in Grand Junction by March and Platte Valley Medical Center in Brighton by January. SCL also has 150 clinics in Montana and Colorado.