Sideris, Weir, Schmalfuss, Bozkurt, Lewis, Sallam, Hanff, Schofield, Pipke, Larimer, Davis, Beauchamp, Hanson, Stehlik
In the vanguard phase, comprehensive implementation program was developed and examined integration of non-invasive remote monitoring and subsequent algorithmic response to the clinical workflow. Clinicians responded to notifications within 24 hours in 95% of instances and clinical action was taken in 25% of instances. Challenges included over-alerting, time needed for data review, staffing, and deference to other providers. The results of the vanguard phase were used to make the following protocol adjustments: 1. Refinement of the algorithmic response to predictive alerts (Figure 1); 2. Expansion of clinician education; 3. Improved education of study subjects on the meaning of predictive notifications; and 4. Aggregating repeated MCI alerts within 72 hours into a single event.