Authors (including presenting author) :
Leung KY(1), Lui CT(1), Wong CY(1), Wu YH(1), Siu HN(1), Tsang LS(1), Lee SN(1), Chan YC(1), Wong WM(1), Chan Peter(2), Lam Jennifer(3), Wong Henry(4), Liu Billy(4), Sung WL(5)
Affiliation :
(1)Department of Accident and Emergency, NTWC (2)Department of Information Technology, NTWC (3)Quality and Safety Division, NTWC (4)Hong Kong Telecommunications (5)Medisource
Keyword 1: :
Patient monitoring
Introduction :
Patients could deteriorate anytime in a busy A&E with natural disease progression, timely recognition and intervention is crucial to prevent adverse outcomes. Locating patients (e.g. hearing impairment or language barrier) is challenging, and missing high-risk patients (especially psychiatric or dementia patients) could pose significant risks. To reduce occurrences of unaccounted-for and missing patients, NTWC A&E worked with technical industry and codeveloped R-PALM wearables.
Objectives :
Develop and implement an integrated system using an all-in-one wearable to enable 1) prompt recognition of patient deterioration via vitals monitoring and 2) patient location tracking and geofencing.
Methodology :
A user-friendly mobile app and portal system were developed to facilitate real-time monitoring of vitals and location. The system triggers alert upon detecting abnormalities including vitals deterioration and geofencing alerts, enabling prompt identification and intervention in A&E. The system notifies frontline through active push notifications on working mobile app and dashboard. A soft trial had been piloted in Tuen Mun and Pok Oi Hospital A&E since September 2025. Target patients included patients aged 12 or above with risk of unattended deterioration: 1) Oxygen requirement 2) cardiovascular symptoms 3) isolation cases 4) psychiatric patients. R-PALM supports prompt deterioration recognition in the first two target groups. Application on isolation cases alleviates need for repeated gowning during patient reassessment, while use in psychiatric patients reduces missing risk.
Result & Outcome :
R-PALM had been applied on 356 patients fulfilling criteria since launch. 57 cases of desaturation (16%), 16 cases of bradycardia (4.5%) and 10 cases with tachycardia (2.8%) were detected. Location function with our specially designed 3D map enabled staff to locate patients immediately. 9 isolation cases (2.5%) applied R-PALM, observation efficiency was enhanced with continuous vital monitoring and regularized blood pressure monitoring with remote charting. There were no missing psychiatric patients within this period. R-PALM innovation was awarded Best Enterprise Solution STAR Silver Award in 11th Communications Association of Hong Kong. Upcoming, we would expand the scope to support equipment tracking and stocktaking, further improving A&E efficiency.
