Basically it's an extension for autotest that listens for notification from OS and allows autotest not to scan for file changes permanently while testing only necessary changes. It saves CPU and disk use.
Windows provides an API for File Change Notification called FindFirstChangeNotification http://msdn.microsoft.com/en-us/library/aa365261(VS.85).aspx
It turns out that somebody already made a small ruby-bridge for this you might use for a starting point: http://blade.nagaokaut.ac.jp/cgi-bin/scat.rb/ruby/ruby-talk/36807
There is rb-fchange for Guard.
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