Postoperative Remote Automated Monitoring: Need for and State of the Science

Michael H. McGillion, Emmanuelle Duceppe, Katherine Allan, Maura Marcucci, Stephen Yang, Ana P. Johnson, Sara Ross-Howe, Elizabeth Peter, Ted Scott, Carley Ouellette, Shaunattonie Henry, Yannick Le Manach, Guillaume Paré, Bernice Downey, Sandra L. Carroll, Joseph Mills, Andrew Turner, Wendy Clyne, Nazari Dvirnik, Sandra Mierdel, Laurie Poole, Matthew Nelson, Valerie Harvey, Amber Good, Shirley Pettit, Karla Sanchez, Prathiba Harsha, David Mohajer, Sem Ponnambalam, Sanjeev Bhavnani, Andre Lamy, Richard Whitlock, P.J. Devereaux, PROTECT Network Investigators

Worldwide, more than 230 million adults have major noncardiac surgery each year. Although surgery can improve quality and duration of life, it can also precipitate major complications. Moreover, a substantial proportion of deaths occur after discharge. Current systems for monitoring patients postoperatively, on surgical wards and after transition to home, are inadequate. On the surgical ward, vital signs evaluation usually occurs only every 4-8 hours. Reduced in-hospital ward monitoring, followed by no vital signs monitoring at home, leads to thousands of cases of undetected/delayed detection of hemodynamic compromise. In this article we review work to date on postoperative remote automated monitoring on surgical wards and strategy for advancing this field. Key considerations for overcoming current barriers to implementing remote automated monitoring in Canada are also presented.