More Eyes in the ICU Doctors Watching from Afar Just Might Be the Safety Net That Saves a Patient's Life
Rackl, Lorilyn, Daily Herald (Arlington Heights, IL)
Byline: Lorilyn Rackl Daily Herald Health Editor
It's a Tuesday afternoon, and Dr. Michael Ries is making his rounds through Advocate Lutheran General Hospital's intensive-care units.
He's dropping in on patients, checking their vital signs, writing orders, reviewing lab results, consulting with nurses - the usual stuff.
The unusual part is that Ries isn't actually in the Park Ridge hospital. In fact, he's not even in the same county. He's sitting in front of a bank of computers in a fluorescent-lit office in Oak Brook.
Welcome to the eICU, an innovative way of caring for the sickest of the sick.
The concept of the electronic ICU is simple, even if the technology behind it is not: Critical-care specialists constantly monitor ICU patients from a remote location with the help of high- tech computer software and real-time telemedicine.
With a few clicks of the mouse, Ries can see if an ICU patient's potassium levels need tweaking at Lutheran General and seconds later be 18 miles away at the virtual bedside of a critically ill person at Advocate Good Shepherd Hospital in Barrington.
"The only thing we can't do is touch the patient," Ries said.
The amount of patient information at the "e-doctor's" fingertips is staggering.
On one screen, he can pull up a bedside monitor that tracks the patient's heart rate and other vital signs.
He can prescribe a drug and a few strokes on the keyboard will tell him if the patient is allergic or on other medications that might pose dangerous interactions.
He can see medical records, care plans, X-rays, lab results, trends in temperature and white blood cell counts - and the patient.
Each ICU room is outfitted with a camera, microphone and speaker. When the doctor wants to drop in, he rings a doorbell that lets the patient know there's a virtual visitor.
"Hi, it's Dr. Ries from eICU," the physician said into his headset as an elderly patient's face appeared on the screen. The camera can zoom in close enough for the doctor to check a patient's pupils or read the settings on a bedside infusion pump.
"You're much better than you were yesterday," Ries told the woman, who managed a wan smile for the camera. "I hope you feel better and go home soon."
The first hospital system in the Midwest to start an eICU program, Advocate brought Lutheran General's 34 adult intensive- care unit beds online this spring. Good Shepherd soon followed. By the middle of next year, all 212 adult ICU rooms throughout the Advocate network are expected to be online, starting next month with Good Samaritan in Downers Grove.
"We think this or something like it will become the standard of care," said Dr. Martin Doerfler, vice president of clinical services for Visicu Inc. The Baltimore-based company developed the concept of the eICU, a registered trademark of Visicu Inc.
Officials stress that electronic ICUs aren't a replacement for doctors and nurses at the bedside; staffing levels within hospital walls remain the same.
The eICU serves as an added safety net, a way to reduce medical errors and improve outcomes in a patient population whose average mortality rate hovers between 12 and 17 percent, according to a study in the American Journal of Respiratory & Critical Care Medicine.
"Care really becomes 24-hour care," said Dr. Rod Hochman, chief medical officer at Sentara Healthcare, a six-hospital system in Virginia. Sentara created its eICU in 2000, making it the first in the country to try the technology.
"The results speak for themselves," Hochman said. "In one of the ICUs at Norfolk General, we had an almost 30 percent reduction in mortality over a year. In that one unit, that meant that more than one person every week walked out of the hospital that ordinarily would have never walked out of the hospital. That's a pretty telling statistic. …