1.1

Hello and welcome to the Talking to Patients course. Here, we will be introducing Oxevision and giving you the tools to help you discuss Oxevision with your patients and their families or caregivers. This lesson will take approximately 15 minutes.

1.2

So what’s this lesson about? The goals of this lesson are:

• To better understand Oxevision regarding what it does and does not do
• Be confident in explaining Oxevision to patients and their families or caregivers
• What is Oxevision?
• What data is available to staff and how it will be used and stored.

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1.3 

So what is Oxevision? Oxevision is a vision-based patient monitoring system that helps clinicians deliver safer, higher quality, and more efficient care. 

Oxevision uses an infrared-sensitive camera housed in a secure, anti-ligature housing unit which is positioned between the ceiling and the wall in a patient's room.

Located next to the camera are 2 infrared illuminators. These allow the camera to work optimally both day and night without disturbing your patients. 

In order to use Oxevision, you will be provided with handheld devices, such as tablets, and a touchscreen monitor to allow you to interact with the system.

Please remember, Oxevision is an additional tool to support patient care; it does not replace clinical staff’s judgment or therapeutic care.

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1.4  

Oxevision works to continuously relay information to staff in real time between regular checks and engagement activities. This information includes: 

• Medical grade cardio-respiratory vital signs. Using Oxevision, you can take contact free, non-invasive, spot-check measurements of pulse rate and breathing rate only. This is a FDA Class 2 medical device. To learn more about the medical device, please complete Course 1, Lesson 2: How to Take a Patient's Vital Signs Using Oxevision.
• Oxevision also provides activity-based alerts and warnings informing you of activity which may mean a patient needs help or assistance in their bedroom. To learn more about the activity-based alerts and warnings, please go to Course 1, Lesson 3: How to Monitor a Patient's Activity Using Oxevision.
• Finally, Oxevision provides multiple reports that show additional insight into a patient’s activity and can help inform treatment planning. For more information, please refer to Course 1, Lesson 3: How to Monitor a Patient's Activity Using Oxevision.

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1.5 

The Room Overview Screen. Protecting patient privacy is very important. Therefore, each room installed with Oxevision is denoted by a tile on the room overview screen as you see on this slide. The room tiles will change states and color depending on what the system considers is happening in the room. Patient privacy is protected as you do not see a live video feed of the patient's room on the room overview screen.The information on the screen includes: 

The room tiles, which include the location of the activity in the room, how long the activity has been detected in that location, and the last time a vital signs observation was taken using the Take Vital Signs workflow.

You can expect the following room states to be displayed: 

• White: Oxevision is unable to detect movement in the room. This can be shown as one of the following: “Empty”, “Acquiring” or “Interfered With”.

If “Acquiring” persists or “Interfered With'' is displayed, Oxevision is not able to perform effectively. Please contact us to resolve this.

• Green: The room is occupied and there are no active notifications. It will display the text “In Room” or “In Bed”
• Orange: The room is in a visual warning state and shows you if a person may need help or assistance, or if the room has been “Paused”.
• Red: The room is in an alert state which visually and audibly tells you that a person may need help or assistance.

These alerts will also appear in the alerts panel on the right side of the screen. Here you have the option to view the room or reset an alert.

Please note: If all rooms tiles are not visible, you may need to scroll down on the overview screen.

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1.6 

There are two instances where staff using Oxevision can get direct access to view live video feed. 

• The first is when you are taking a spot-check vital signs observation using Oxevision. Here you will see a  live, up to 15 second clear video feed to verify patient safety. There are 3 reasons we provide clear video feed during the vital signs observation; firstly, to confirm the identity of the person from whom you are taking vital signs, secondly, to ensure the individual is not in visible distress, and finally, to confirm that the individual is still or resting. 
• The second instance you can get direct access to live video feed is if an alert is triggered on the room overview screen and you select the ‘View Room’ button. Once selected, you will see a live, up to 15 second blurred video feed into the room. 

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1.7

However, If configured and approved by your organization, senior staff are able to request and receive blurred video data following the appropriate authorization. The blurred video data is normally only used to support incidents. If configured, blurred video data is stored securely on servers located in your facility. 

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Two examples of when blurred video data can be valuable is when there has been an unwitnessed fall in an Older Adult setting or, when there has been a serious incident on an Acute unit.

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• What can you request? Staff can request for blurred video data to be ‘clipped’ and saved. Requests must be received within 12 months before the data is automatically deleted - Oxehealth’s support line operates 24/7, 365 days a year. Data is transferred in an encrypted format and delivered to a nominated individual.
• Why do we provide this service? For the purposes of serious incident (SI) investigations. It can be shared with ICU and/or police or other external agencies, if required.

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1.8 

Here is an example of the difference between clear video data and blurred video data. Clear video data is what you see when you are taking a spot-check vital signs observation using Oxevision. Here you can clearly identify who the individual is, whereas blurred video data only allows you to see an individual’s movements. You can access blurred video data if you choose to select the ‘View Room’ button following an alert being triggered on the room overview screen. 

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1.9 

If configured on your site, you are able to switch an Oxevision room on and off. When Oxevision is used as part of the standard care offered on a unit, patients and their carers must be informed that it is part of the organization's normal practice. 

If the decision is made in line with your organization's protocol to turn Oxevision off, staff can switch off individual rooms via the “Settings” button on the drop down menu.

When a room is ‘on’ the toggle will be navy. To turn a room off, select the toggle, and it will turn grey. Once turned off, the room state on the tile will change to say “camera off” and you will no longer be able to view into the room, take vital signs, receive alerts and warnings, and request blurred video data (if configured). 

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1.10
Below are some key messages regarding what we have covered so far. 

• Oxevision is an additional tool to support patient care. It does not replace clinical staff’s judgment or therapeutic care. You should never rely solely on the system to ensure patient safety and always carry out your usual, in-person safety checks.
• Unit staff can only see live video feed in two instances:

• When taking pulse or breathing rate measurements using Oxevision Vital Signs (clear video)
• When responding to a notification from Oxevision (blurred video).

• If a patient objects and requests for Oxevision to be turned off, please follow your organization’s protocol.
• The combination of warnings and alerts are configured per unit as they are tailored to the specific needs of the patients on that unit.
• This is not a product training session. You will still need to complete your full Oxevision product training either by attending one of your unit specific training sessions run by Oxehealth or via OxeAcademy.

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1.11

During this part of the lesson, we will be outlining key areas of discussion when explaining the Oxevision system with your patients and their families or caregivers.
These are intended to be:

• Easy to remember
• Easy to understand in order to discuss with patients
• Patient centered

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1.12

These key areas of discussion are designed to work in parallel with your patient information leaflet. 

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The first key area of discussion is: Where is Oxevision installed?

During this discussion, you can say:

The “white box” in the room is the Oxevision system. Within this box is an infrared-sensitive camera with infrared lights that are there to help staff monitor patients' safety without disturbing them. 

It is installed in all of the rooms on this unit and is a routine part of how we look after patients.

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In order for staff to use Oxevision, they have handheld tablet devices, and a touchscreen monitor located in the nurses’ station.

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1.13

A second key area of discussion is: What does Oxevision do?

During this discussion, you could highlight:

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• Oxevision contains a medical device that uses an infrared-sensitive camera to measure pulse and breathing rates
• It lets staff know where patients are in their room
• It shows staff how active patients have been. For example,Oxevision can let staff know how long a patient has been resting and how long that individual has been active
• Patients may notice a red "glow" from the unit in their bedroom. This is the infrared light which is on all the time and is not a sign that the camera is working 

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Please remember, Oxevision is an additional tool to support patient care. It does not replace clinical staff’s judgment or therapeutic care.

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1.14

A further key area of discussion: What kinds of notifications and information will staff receive from Oxevision?

During this discussion, you could say:

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Oxevision works to continuously relay information to staff in real time between regular checks and therapeutic activities. This information includes: 

• Contact free, non-invasive, spot-check measurements of pulse rate and breathing rate
• Activity-based alerts and warnings to inform staff of activity which may mean a patient needs help or assistance in their bedroom
• Reports showing additional insights into a patient’s activity that can help inform treatment planning

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Oxevision cannot monitor all patient activity. If a patient needs help, advise them to always speak to a member of staff.

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1.15

Another key area of discussion is: When can staff see into a room using Oxevision?

During this discussion, we advise being open and transparent with the patient. You could say:

Oxevision is not a constant video feed like CCTV. Staff can only see live video into a room for up to 15 seconds using Oxevision  on two occasions:

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• When staff are taking a spot-check vital signs observation. Here staff will see a live, up to 15 second clear video feed so that they can verify patient safety.
• If an alert is triggered on the room overview screen and staff choose to select the ‘view room’ button. Once selected, staff will then see a live, up to 15 second blurred video feed into the room.

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1.16

A final key area of discussion is: What data do staff and Oxehealth have?

During this discussion, you could say:

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Personal data and protected health information is protected by federal law under HIPAA (Health Insurance Portability and Accountability Act).

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If approved by your organization, senior staff are able to request and receive blurred video data following the appropriate authorization. Blurred video data is normally only used to support incidents. 

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For example, blurred video data may be used when there has been an unwitnessed fall in an Older Adult setting  or, when there has been a serious incident on an Acute unit .

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At Oxehealth, patient privacy and dignity are taken very seriously. As such,we have strict data privacy processes in place.

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1.17

There are other resources available to help support you with more in-depth Oxevision questions. Some of these resources include posters and leaflets created by Oxehealth in collaboration with your organization.  This informative packet includes:

• A Patient and Family or Caregiver Information Leaflet for use on admission and on the unit
• A Patient and Family or Caregiver Poster for use in public areas of the unit
• An additional “Information Sheet” to support with staff and patient conversations
• Additional information on privacy and data, including Oxehealth’s role as Data Processor, can be found in the Further Information on Privacy and Dignity resource 

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1.18

Below are some key messages regarding what we have just covered: 

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• All patients must be informed on the use of Oxevision, and their consent decision must be documented in line with your organization's chosen consent model.
• Ensure you have a copy of the Oxevision Poster and Patient Information Leaflet available when speaking to a patient, family member, or caregiver to support your conversation.
• Oxevision is an additional tool to support patient care. It does not replace clinical staff’s judgment or therapeutic care.
• Oxehealth takes patient privacy and dignity very seriously.there are strict data processes in place to protect patient privacy.  
• Any questions on the clinical use of Oxevision should be directed internally, and usage should be in line with your organization's protocol.
• Oxevision product training is available and must be completed by staff to use Oxevision. You can complete the Oxevision product training by completing Course 1 - What is Oxevision and How to Use It.

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