Feasibility and acceptability of smartphone technology for patients to self-record vital signs in the emergency department (The FacED Study): a study protocol

Introduction

Overcrowding and nursing workload are two major issues within urgent and emergency care (UEC) settings and contribute to incompletion or omission of patient vital signs in initial assessment and patient monitoring. This could potentially have a negative impact on patient health outcomes. Software enabling contactless monitoring of patient vital signs using camera photoplethysmography (PPG) has been developed, where patients can measure their own vital signs by recording a 30-second video on their smartphone on the software platform. This software could prove beneficial within UEC settings to help to reduce nursing workload and allow prioritisation of higher order tasks and could help to reduce long wait times for initial triage assessment. Before any such software can be implemented, it is first necessary to assess the feasibility and acceptability of the software in situ among patients in UEC settings, as well as the acceptability among staff working in triage.

Methods and Analysis

To assess feasibility of the software, 1500 patients attending three UEC services at St George’s University Hospitals NHS Foundation Trust will be invited to take part in a study where vital signs will be measured manually and using smartphone PPG software. Feasibility will be measured using a survey after data collection. Staff acceptability will be measured using a short survey among 20-40 staff. Patient acceptability of digital health technology in UEC settings will be measured by a questionnaire among 10,000 patients.

Ethics and Dissemination

This research has been ethically approved by the NHS London – Surrey Research Ethics Committee and the Human Research Authority (reference: 25/PR/0222; IRAS project ID: 346745). Informed consent will be obtained prior to the participant undergoing any activities that are specifically for the purposes of the study. Findings from this research will be disseminated via journals and conferences and used to inform further research in the field.

Strengths and Limitations

• This observational study aims to assess the feasibility of using novel photoplethysmography (PPG) technology to measure vital signs in the Emergency Department

• Whilst several studies have explored the use of PPG, FacED will ascertain if this can be correctly used by patients in the ED

• The study includes several outcomes and will generate data on the acceptance of digital technologies in ED care

• The ability to recruit from three urgent and emergency care (UEC) settings within one NHS Trust is a strength of this research as it will enable a wide range of participants to be recruited from across emergency care, making the study target sample sizes more attainable and will provide feasibility assessments in 3 locations.

• This feasibility study will test the appropriateness of the methods to answering the study question but at present, the study materials are only accessible to English-understanding patients and data will be collected on participant’s first language