Outcomes Articles

Your Monitoring Tool Sends an Alert. Who Will Act on It?

October 14, 2026

About This Report

Featuring insights from Nayan Patel, Andrew Malcolmson, and Brian Tufts hosted by our CEO, Saul Marquez.

An early warning can arrive while a nurse is checking patients, answering messages, and keeping up with routine care. The signal may be clear on a demo screen. The harder questions are where it appears during a shift, who assesses the patient, and how the next action fits the team's existing responsibilities.

Nayan Patel knew those competing demands from his years as a hospital CIO. Discussing contactless monitoring at Neteera, he preferred meaningful alerts delivered through existing nurse-call stations or handheld devices rather than another stream of readings in the electronic medical record. His concern was practical: put a signal where a nurse can use it.

A monitoring trial needs evidence of what the tool detects and what the hospital does with the warning. Before describing earlier detection as patient benefit, agree with the clinical team on the recipient, the assessment owner, and the local response. Performance evidence matters, but it cannot fill in those responsibilities.

Put the Warning Where Someone Can See It

Where will the nurse actually see the warning? Hospitals already use nurse-call stations, handheld devices, patient-monitoring displays and electronic records, often for different jobs. Simply making an alert available in one of those systems doesn't establish that the right person will see it during ordinary care.

In his Outcomes Rocket conversation, Nayan described Neteera's radar-based technology, which captures physiological signals without requiring the patient to wear an additional device. He discussed tracking changes against a patient's baseline and notifying staff when a relevant change is detected. His discussion focused less on collecting every possible reading and more on what nurses could use when deciding whether somebody needs attention.

Nayan also emphasized getting clinicians involved before implementation and finding work the technology could remove rather than adding another task. That's an implementation objective, not a measured staffing reduction. Any change to routine vital-sign checks would require clinical approval and appropriate validation. For the trial, agree on the actual destination and recipients before treating the alert channel as solved.

Match the Monitoring System to the Care Setting

The destination matters, but it has to work with the hospital's actual monitoring equipment. A deployment in an ICU with continuous ECG monitoring may be different from one on a floor where that infrastructure isn't installed. The commercial proposal should identify those differences before promising an easy rollout.

Andrew Malcolmson explored this in his September 2023 Outcomes Rocket conversation about Fifth Eye, where he was then CEO. He described software that analyzes ECG waveforms for indications of physiological instability and presents results alongside familiar measures such as oxygen saturation and respiratory rate. Clinicians could encounter the analysis in the monitoring environment they already use, rather than keep a separate application open all day.

Andrew's deployment argument depended on existing infrastructure. He explained that critical care, stepdown and telemetry environments with installed ECG could be comparatively straightforward. Areas requiring wearable patches or other equipment involved more work. His description was conditional, not a claim that every hospital system, sensor or clinical setting could use the software without modification.

During the hospital review, write down the care area, population, installed sensors, supported interfaces, needed hardware, display location and implementation work. Confirm those details with clinical staff and IT rather than relying on a demonstration from a different unit. If the technology is proposed for a new care setting, review its intended use and validation evidence there. Once the signal can reach the right screen, another decision remains: who decides what the warning means for the patient?

Define Who Assesses the Alert and What Happens Next

An early warning gives the clinical team an opportunity to assess a patient more closely. It cannot, by itself, specify which intervention is appropriate or prove that a patient will benefit. Andrew made that distinction when discussing early indications of instability before a rapid-response event.

In the 2023 interview, Andrew reported a University of Michigan observation of 111 patients who experienced rapid-response events in ECG-monitored clinical areas. According to his account, warning signs appeared more than 24 hours in advance in over 90 percent of those cases. The interview doesn't supply the full study methods, all monitored patients, false-positive rate or a comparison showing improved outcomes. It is a guest-reported result in a selected group, not general prediction accuracy or proof of prevented harm.

Just as important, Andrew explained that increased vigilance or other interventions would depend on the hospital's own protocols. The hospital might decide closer observation is appropriate in one situation and a different assessment is needed in another. The algorithm's warning doesn't replace that clinical decision.

Once somebody sees the alert, who owns the assessment? Brian Tufts described a more task-specific example in his Outcomes Rocket conversation about Ambient Clinical Analytics. Its Sepsis DART application combines detection based on a hospital's sepsis definitions with workflow support for that institution's response procedures. He discussed tasks such as fluids, antibiotics and additional lactate measurement as examples of what local protocols might require, not universal treatment instructions.

Brian also distinguished the system's rules-based clinical model from AI tools the company was exploring for faster implementation and workflow analysis. His explanation does not describe generative AI making autonomous treatment decisions. Local clinicians and the hospital's approved protocol remain responsible for medical decisions, including whether and when a task is appropriate.

For the deployment agreement, identify the professional or team that reviews the warning, the process for clinical assessment, the person responsible for the next task and the handoff when responsibility changes. Decide how that work is documented. Without these details, the product may deliver an alert while the trial still lacks an agreed way to determine what followed.

Measure the Warning and the Response Separately

A trial may show that a model identifies concerning physiological changes while leaving the operational effect uncertain. Hospitals need to examine both the detection result and the clinical work it generates. A strong retrospective prediction figure doesn't tell a buyer how many notifications staff will receive during an ordinary shift.

Brian's institution-defined workflows add another measurable point: whether an assessment leads to the response tasks required by the local protocol. A task being recorded as complete is not necessarily proof that it was clinically appropriate. The clinical team needs to define the applicable circumstances and review the quality of the response, not just count clicks in software.

Keep model performance, alert burden, documented assessments, completed appropriate responses and patient outcomes as separate measures. Assign an owner for each and decide how the trial will collect the evidence. That gives the commercial team a more credible basis for discussing value, with the important limitations still visible.

Agree on the Response Before Expanding the Trial

Before committing to deployment, get nursing and clinical leaders, operations, IT integration staff, product and commercial teams, and the people evaluating results into the same review. Leave with a written specification for this deployment that the relevant hospital teams can approve:

Care setting: intended patient population, sensors, installed infrastructure, and any additional hardware or interfaces.
Warning: where it appears and who is assigned to receive and assess it.
Clinical response: which hospital-approved protocols determine subsequent tasks.
Handoffs and documentation: how ownership transfers and how the assessment and subsequent work are recorded.
Evidence: named owners and collection methods for model performance, alert burden, assessments, completed appropriate responses, and patient outcomes as separate measures.

Proceed with a defined unit and response pathway when the infrastructure, roles, and evidence plan are adequate. Narrow the trial when a different population or care area changes those conditions. Hold expansion if the clinical team cannot identify the assessment owner or show how an appropriate response will be evaluated. The specification should describe this deployment; it is not a universal response protocol.

At the next deployment review, ask the clinical team to walk through one warning from its destination to an owned assessment and the next locally approved step. Nayan's familiar-device example, Andrew's hospital-protocol distinction, and Brian's task-specific workflow give you different parts to inspect. Require a named assessment owner and a plan to determine whether the appropriate response occurred before making the next commitment.

About the Conversations

These are three separate Outcomes Rocket conversations, not a shared case study. During the time of recording, the guest names and titles were as follows: Nayan Patel, Senior Vice President and General Manager of Transformation and Digital Health at Neteera. Andrew Malcolmson, President, CEO and Board Member of Fifth Eye. Brian Tufts, President & CEO at Ambient Clinical Analytics.