What Is a “Modern” Central Monitoring Unit (CMU)?

Before examining the modern CMU, first consider the older – and often ad-hoc – ways health systems and their hospitals watch over patients flagged for additional oversight of heart rhythm and rate or SpO2:

Despite the best efforts of the teams involved, these older approaches often fall short: The start of monitoring delayed. Patient information mixed up. Detection of deterioration slowed or missed. Miscommunications taking place between monitor techs and clinicians. And the cacophony of false or non-actionable alarms continuing unabated.

Next-generations CMUs address ongoing challenges with innovative features and workflows

Modern CMUs provide solutions with true clinical support and patient safeguards, drawing upon years of experience developing and operating the environments where remote telemetry monitoring takes place.

Some of these CMUs are further refined than others – picture a spectrum going from solid foundation to enhanced and then to optimized. Still, they share key features, embracing not only today’s advanced tools but ready to incorporate tomorrow’s evolutions and innovations:

Tapping the monitoring innovations now available, health systems may choose to update CMUs at individual hospitals. Doing so, however, does not provide the full benefits of a single, connected hub, one with a truly centralized approach to telemetry monitoring.

These hubs can serve multiple hospitals – perhaps even the whole integrated delivery network. They can sit in an existing care location or an offsite building within the health system — even one hundreds of miles away, if data transmission is not overly delayed. While precise capabilities depend on the installed solution, hubs can scale relatively easily for additional care sites and patient surges, unlike individual CMUs.

In theory, health systems can update CMUs without consideration for monitor tech comfort. In practice, planners recognize that seated screen-watching can induce mental and physical fatigue, potentially impacting patient safety. Ergonomic furniture, acoustic paneling, ambient lighting and exercise equipment represent examples of their responses. These features not only support focused monitoring, but also staff recruitment and retention.

With telemetry patients often scattered across floors, monitor techs and bedside teams require swift and consistent communication. Many modern CMUs go beyond landlines and pagers, with systems that track responses, escalate unanswered alerts and provide context, to various degrees. The most sophisticated approaches allow nurses to take action on smartphones across the hospital, freeing them from the bedside or central station when not needed for intentional care.

Long-awaited connections to ADT and EMR systems solve many past challenges. CMU teams can ensure patients get needed oversight from their assigned telemetry monitors, while gaining visibility to the clinicians responsible for care. Greater interoperability also means CMU and bedside teams can gain insights from connected, non-telemetry medical devices, when needed.

EMR integration means the end of a long-standing but time-consuming practice: the printing, cutting, pasting and scanning of wavestrips. Instead, monitor techs can digitally measure, annotate, save and export wavestrips straight to the patient’s medical record, along with additional documentation. Clinicians then gain readily available access for viewing and validating.

While the CMUs in question remain rooted in traditional telemetry deployment, teams can extend monitoring to other care areas and needs. They can incorporate other physiologic parameters and extend cardiac and oxygen saturation oversight to emergency departments and higher-acuity monitors in intensive care and step-down units.

Without meaningful information, it’s difficult to identify areas for improvement, let alone enact the required changes. A centralized hub connects a larger pool of patient data, while a modern system can provide tools to capture, analyze and share it. By unlocking insights, health systems can address challenges such as alarm management and appropriate telemetry use.

With a shared network, a modern CMU simplifies technical infrastructure and administration and reduces access points. Some solutions even make the installation of software updates and security patches for PCs and servers easier. For hardware, a modern hub can support centralized inventorying of telemetry monitors, potentially avoiding manual counts or the need for RFID trackers.