Figure 5.

Exemplar augmented e-obs chart from the Clinician Dashboard, showing wearable and e-obs vital-sign data from a COVID-19 patient in the isolation room. The header provides the patient's demographics (from left to right): the ward, bay and bed location, the name, gender, age (with date of birth below), and the MRN and NHS codes. The clinicians have the option to “Edit” the patient information, or “Terminate” the patient's session in the vHDU system (automatically unregistering them from the assigned tablet). The clinicians can review the periodic wearable data, i.e., the 5-min median estimates, using 15-, 30-, or 60-min windows (the most recent 5-min estimates in each window are shown), alongside the intermittent e-obs data (usually entered 4-hourly by the nurses), to facilitate tracking of the patient state. Wearable data is distinguished from the e-obs by using the Bluetooth sign at the top of the Temperature row. Only the e-obs data have scores associated with it, presented in the T&T row at the top and bottom of the chart. In this hospital setting, an Early Warning Score greater or equal to 3 was coloured red, denoting high risk. In this exemplar patient chart, only nurse observations (e-obs data) are present at the start, showing low SpO₂ (89% at 2:30 AM) and high RR, high Temp, and the use of oxygen therapy (26 rpm, 37.9°C and Venturi mask 60, V60, at 15 litres per minute, respectively, at 6:35 AM). The wearable data is summarised in hourly windows to allow the review of a longer monitoring period. It is possible to observe that during this period the VitalPatch® and the Nonin devices were fitted to the patient from 13:00 and then temporarily removed between 16:00 and 23:00. Periodic VitalPatch® data was then consistently available for remote monitoring of the patient status from the nurse bays; however, the Nonin was still removed often by the patient during that period (staff continued to try to use it to monitor the patient's continuous oxygen therapy, which can be confirmed by the presence of the Venturi mask, V40, in the 4-hourly e-obs data present during this period). MRN, Medical Record Number; NHS, National Health Service; T&T, Track & Trigger; Sats, peripheral blood Oxygen Saturation; AVPU, Alert, Voice, Pain, Unresponsive scale; GCS, Glasgow Coma Scale; RA, Room Air; O₂, Oxygen.