Royal Perth Hospital: A big step forward in virtual healthcare as AI-enabled beds keep patients out of ICU

Artificial intelligence is freeing up intensive care beds and slashing thousands in costs for patients recovering from spinal surgery at a WA hospital, an international study has found. Research published in the Anaesthesia and Analgesia medical journal — which looked at 288 surgery admissions for scoliosis at Royal Perth Hospital over the past five years — showed that the groundbreaking 24-hour remote monitoring technology was saving an average of 27 hours in the ICU and $2682 per patient. The Health in a Virtual Environment system sees those who have been operated on for scoliosis — a sideways curvature of the spine — go to a general ward instead where they are continuously remotely monitored in a bed connected to specialist staff elsewhere in the hospital. AI technology is then used to monitor vital signs and alert hospital staff of potential issues, who can then use a two-way audio and visual system to communicate with the patient. Those requiring an operation would traditionally spend at least 24 hours in ICU after the complex surgery because of the pain and the risks of the strong medication they are given. RPH and Armadale Health Service were the first in Australia to use the HIVE when it launched in 2020, which has been used for more than 15,000 patients since. The technology has also been used with other elective surgeries, such as hip and knee replacement and colorectal, as well as conditions including respiratory infections, septicaemia and cardiac arrest. It is also now being used in aged care homes and home hospital services. RPH spinal surgeon David Dillon said using the technology for scoliosis patients was crucial in freeing up ICU beds, especially given the surgery was not performed at any private hospitals. Darcy Wilson, who recently underwent scoliosis surgery at RPH, said she felt safe knowing there was an extra set of eyes watching her vital signs at all times whilst she recovered in the 5G general ward. “Being in ICU would obviously have been a much more confronting experience but because there is now this HIVE technology, I have felt so safe and so comfortable after my surgery,” the 17-year-old said. “The hospital staff have been nothing short of amazing too and they have helped me immensely.” Dr Dillon said hospitals had previously been forced to cancel surgeries if there was no space in intensive care, which could make the medical condition worse. “Although the patients are largely young, fit and healthy, the surgery is really quite an insult to their physiology. It’s quite a big surgery to undergo, and routinely they need careful monitoring post-surgery for the first 24 hours at least,” he said. “Although the hospital did its very best to ringfence the (ICU) beds for the scoliosis surgeries, obviously there is a competition with trauma and the unexpected that comes through the doors. HIVE is a concept whereby the same standard of monitoring is delivered remotely. It is a system where there’s a central hub with monitors for each patient and those patients are then managed in various beds throughout the hospital.” Dr Dillon said the HIVE system brought predictability for operations to go ahead as scheduled. “It has been proven to be a safe and predictable pathway. It’s increased the other surgeries that flow on afterwards. Our waiting list speaks for itself. We have a very low waiting list. There’s not a single over-boundary scoliosis patient,” he said. Nurse unit manager Gemma Easthope said the system included a physiological monitor that is used in ICU and artificial intelligence to identify trends based on the individual patient. “They can be alerted if something’s happening that perhaps the nurse in the room doesn’t know,” she said. “There’s a screen and a video camera that turns around so that we can talk straight to the HIVE team.” Health Minister Meredith Hammat said HIVE was an example of how the State Government is investing in innovative healthcare solutions to address the challenges that increased demand is having on our health system. “It’s incredible to see the work being done in our public hospitals recognised and celebrated internationally,” she said. About three per cent of the nation are affected by scoliosis, with roughly three in 1000 cases needing surgery.