Intelligent alarm system helps Danish Covid-19 patients

It will now be easier for Danish hospitals to keep an eye on sudden deteriorations in the condition of patients with Covid-19. An artificial intelligent system with wireless 24/7 monitoring of patients is being distributed at Danish hospitals. Initially, Rigshospitalet, Bispebjerg and Frederiksberg Hospital will start using the system. But the Danish Regions have granted resources for up to 250 units to relieve the pressure on hospital staff and secure the best possible patient care in the hospital wards across the country.

The system is called WARD (Wireless Assessment of Respiratory and circulatory Distress) and has been designed and tested by Research Leader Helge B.D. Sørensen and his research group at DTU Health Tech. It has taken place in collaboration with medical professionals and researchers from Rigshospitalet and Bispebjerg and Frederiksberg Hospital. During the first wave of the pandemic in the spring, the system was finalized and tested on 100 patients.

The researchers have designed knowledge-based algorithms, which in real-time can follow the development of the condition of the individual patient and raise an alarm, when critical disease levels are reached. The system can become an important tool in the fight against Covid-19, but also in general for critically ill patients, Eske Kvanner Aasvang, Chief Physician and responsible for research at the Department for Anaesthesiology at Rigshospitalet and one of the developers of WARD, explains.

”An experienced medical doctor can usually rather easily evaluate when a patient’s condition deteriorates, but in the middle of a pandemic, there is often a shortage of doctors and nurses, who can monitor the patients 24 hours a day. Therefore, we now use our wireless WARD alarm system, so nurses are contacted automatically on their dedicated phones with alarms, if the artificial intelligence has estimated that a patient with Covid-19 reaches critical levels. There is a huge potential in knowledge-based systems that use wireless sensors, and we believe that the combination with artificial intelligence in a system like ours will save a lot of lives because we can detect deteriorations much earlier”, Eske Kvanner Aasvang says.

Big help for wards under pressure

The clinical support system WARD consists of small sensors that are placed on the patient, and a mobile unit that sends raw data to a bigger computer in the cloud. Here the algorithms constantly work and learn to continuously catch the smallest signs of deterioration and raise an alarm – likewise the system sorts out irrelevant fluctuations to avoid alarming the staff unnecessarily.

The system provides security and enables efficient supervision of the patients – also for staff, who do not have experience with monitoring Covid-19 patients. This is the point of view of co-developer Christian S. Meyhoff, who is Chief Physician and responsible for research at the Department for Anaesthesiology at Bispebjerg and Frederiksberg Hospital.

“The WARD system can be a great help for all over-loaded wards that have patients with Covid-19 admitted, and do not have electronic monitoring of patients to the same degree as the intensive care units. With the wireless sensors vital parameters for the patients are monitored and interpreted, which gives a security and lets the staff close the door to the patients safely”, Christian S. Meyhoff says.

He explains that the progress of the disease demands constant surveillance of vitals such as oxygen saturation, respiration and circulation. A large deviation in one of these do not necessarily mean danger. On the other hand, a combination of several moderate deviations can signify that the patient is heading towards a critical stage, and these deviations are registered by the artificially intelligent system.

According to Christian S. Meyhoff another major advantage of WARD is that there is no need for direct physical contact between patient and practitioner, which reduce risk of infection for the medical staff.

Health technology contributes to better hospitals in the future

The WARD system will change the current clinical practice, where we due to limited resources only manually measures vitals a few times per day on admitted high-risk patients, including Covid-19 patients. Associate Professor and Research Leader Helge B.D. Sørensen, Biomedical Signal Processing & AI Research, DTU Health Tech, explains that the inspiration to how WARD is developed is found in the medical doctors’ clinical work.

”We have asked the medical doctors to describe scientifically how they analyse the patients’ signals and find complications based on these. Following this, we have developed knowledge-based mathematical models, which automatically estimate these complications and early biomarkers for these complications. The system forwards alarms based on an estimation of the complications”, Helge B.D. Sørensen says.

According to Helge B.D. Sørensen, the close collaboration between the doctors at Rigshospitalet and Bispebjerg and Frederiksberg Hospital is the foundation for making our research a success. By taking departure in the challenges of the health system, the researchers can invent new and innovative solutions interdisciplinary.

”We are currently seeing a good example of collaboration, where nurses and doctors evaluate and make demands to how the WARD system’s mobile phone user-interface should be. We have given them free rein to make wishes for the design, as they would like it to be, because we have to make sure that they want to use the system, Helge B.D. Sørensen tells.

Tested on the most critically ill

The WARD project was originally developed to monitor e.g. circulation and respiration after major cancer surgeries or hospitalization of high-risk patients due to severe medical illness such as cancer or acutely deteriorating Chronic Obstructive Pulmonary Disease (COPD). With the Corona pandemic outbreak, it was a clear-cut opportunity for the researchers to test the system on patients with Covid-19, and they received funding for the project from among others The Novo Nordisk Foundation and Danish Regions.

The system has until now been tested on the most critically ill. And here the researchers can see that 70% of the patients have had very prolonged courses of illness with among other things impaired oxygenation – long-term deviations that occur frequently during the daytime.

Looking ahead, WARD is still an ongoing research project, and admitted patients with Covid-19 will be invited to take part in the research project. Researchers will at the same time include surgical and medical patients to these tests.