Intensive care units (ICUs) cater to patients with the most severe and life-threatening illnesses and injuries that require constant, close monitoring and support. Staffed by highly-trained doctors and critical care nurses who specialize in caring for seriously ill patients, ICUs admit some five million adults every year in the U.S.
ICUs are said to account for up to 30 percent of a hospital’s costs, and the burden is expected to grow over the next few decades, as hospitals prepare for what some say will be an explosion of new patients amid an increasing elderly population.
Enter eICU technology, which can provide care to patients in multiple hospitals, with the goal to optimize clinical expertise and facilitate 24-hour-a-day care by ICU caregivers, whether the caregivers are down the hall from the patient that's being monitored or in another city.
According to statistics, in the U.S., more than 300 hospitals in more than 40 health systems across 34 states take advantage of eICU services. Adoption levels are sometimes lower in rural areas, but that number is expected to rise as rural healthcare customers get access to high-speed Internet service.
In Arkansas, on the sixth floor of the Baptist Health Eye Center building on the Baptist Health Medical Center-Little Rock (BHMC) campus, eICU technology is one of the latest advancements that allows for patient monitoring of critical care units throughout the system.
The eICU control center acts as an air traffic control center, giving the ICU staff an extra set of eyes and ears, says Vicki Norman, R.N., director of eICU care at Baptist Health, which includes eight Arkansas medical centers. Baptist Health eICU care contracts with 20 hospitals and 223 beds, over two states. Seven of the 20 hospitals are part of the Baptist Health system and 13 are hospitals outside the Baptist Health system, Norman says.
The two-way video and “cockpit-like sensors” of this technology enable the eICU care staff to detect even the slightest change in the patient’s condition and communicate more effectively with the bedside team to reduce the time between problem identification and intervention.
“This technology is just on the edge of being more widely adopted,” says Norman. “There is a tremendous opportunity for telehealth in general, and eICU is quickly being recognized for delivering a better standard of care. “We are looking at it as a quality care delivery model,” she says.
Vicki Norman, R.N.
At Baptist Health, physicians and nurses are staffed in the eICU control center and act as additional support to monitor critical care patients, and provide faster response times through use of computer technology as well as audio and video components. Norman says there is a staff of 15 critical care physicians and 25 critical care nurses in the control center, of who average 20 to 25 years of experience.
With the eICU technology, every critical care room will be equipped with a camera as well as a microphone and speaker that enable staff in the control center to communicate with staff and even the patient in the room. If the camera is turned on to monitor the patient, a bell rings and the camera rotates to indicate that it is in use, Norman says.
The key element to the eICU control center is the software from the Andover, Mass.-based Philips that enables the physician and nurse team to monitor every critical care patient at once. The software's Smart Alert automated monitoring and notification system continually analyzes data on patients to pick up problems on the front end long before they could be noticed physically. “The patient’s information is put into our electronic medical record (EMR), and then our software runs screens in the background looking for trends over time, and lab results and vital signs, all specific based on diagnosis, age, pre-existing conditions, etc.,” says Norman.
“We get a signal, we put on our headset, and in matter of seconds, we have a caregiver who can be virtually at the patient’s bedside,” says Norman. Previously, she explains, the staff in the ICU would have to go through a paging or answering service, which could take five minutes, 15 minutes, or an hour or more if the caregiver may not be able to come right away if he or she is in another surgery.
According to Baptist Health officials, studies of healthcare systems that have implemented an eICU control center show a 27-percent reduction in mortality rate and a 17-percent reduction in length of stay, primarily because patients are being watched more closely and with quicker interventions. Patient time spent on ventilators has also shown to be reduced.
Baptist Health also recently participated in a competitive bid process to provide services to the General Leonard Wood Army Community Hospital based in Fort Leonard Wood, Mo, says Norman, adding that Baptist Health was awarded the contract to provide eICU services for the Department of Defense to U.S. Army active duty personnel, their dependents and U.S. military retirees—the first civilian contract of its kind, she says.
There, this technology could be especially beneficial—similar to the benefits it has in rural hospitals— when often families of patients feel distressed when loved ones are shipped to a hospital 90 miles away, Norman says. “It’s a help for the hospitals to retain their patients, provide care at home, build confidence, and improve quality of lives. Physicians now have the peace of mind that someone is always watching over their patients.”