Pilot and Feasibility Deployment of an Advanced Remote Monitoring Platform for COVID-19 in Long-term Care Facilities

Jessica R. Walter MD; Dong-hyun Kim BA; Daniel Myers BA; Marc Hill BA; Brooke Snoll BA; Jong Yoon Lee BA; Elena Kulikova BA; Katherine Fagan BA, MA; Raclyn Cauinian BS; Lily Nguyen BA; Mark Shapiro PhD; Fernanda Heitor MD; Katherine T. O'Brien MD; Shuai Xu MD


J Am Geriatr Soc. 2022;70(4):968-971. 

In This Article


This is a fully virtual single-arm, prospective observational study of older adults in two LTCFs (Chicago, IL) of the ANNE One (Sibel Inc.), an Food and Drug Administration (FDA)-cleared physiological monitoring system (Figure 1A), consisting of two medical-grade silicone patches. A chest sensor is positioned at the suprasternal notch by biocompatible, conductive adhesive, while the second is wrapped around the index finger. The chest unit has a 1-lead electrocardiogram, 3-axis accelerometer, and temperature sensor, capturing continuous heart rate (HR), respiratory rate (RR), chest wall movement, snoring, respiratory sounds, seismocardiography, body position, and temperature.[7] The ANNE limb sensor has a photoplethysmograph, and temperature sensor, capturing pulse oxygenation, HR, perfusion index, and peripheral arterial tonometry. The two units are time-synchronized generating pulse transit time and continuous blood pressure.[8] Sensors record data and automatically download it to the cloud and tablet via encrypted Bluetooth.[7]

Figure 1.

The ANNE sensor system is shown deployed on an older adult LTCF resident (A). In panel (B), the data outputs in a 60-second snapshot are shown with continuous 1-lead ECG for heart rate and respiratory rate), photoplethysmograph (PPG) for SpO2, seismocardiograph (SCG) for heart sounds and respiratory sounds, accelerometry (ACC) for motion, and temperature (TMP). (C) Scalable model for remote deployment of an advanced wireless continuous monitoring system for LTCFs during pandemic situations

Patients with active skin conditions, major psychiatric disorders, or inability to consent were excluded. LTCF staff were virtually trained and applied the system to patients, after virtual consent. Participants wore sensors for up to 14 days and completed questionnaires regarding comfort and usability. Skin was evaluated for injury after sensor removal. Patient demographics, HR, RR, pulse oxygenation, cough count, position, and snoring were collected. Advarra Institutional Review Board (STU00213706) approved the trial.