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Remote IT Lets Docs Care for ICU Patients From a Distance

Lucas Mearian | March 4, 2011
When Leo DeFault had what should have been a fatal heart attack almost three years ago, it was an alert bystander who knew CPR that kept him alive. But once he was at a community hospital, it was a critical care physician -- who was 25 miles away -- who saved his life through a remote IT system.

In a typical ICU, during night shifts physicians respond only to emergencies when paged by charge nurses. The nurses can do very little, for example, if a patient experiences an irregular heart rhythm that could harm his health.

"[The nurse] can't even put in a urinary catheter without an order," Shaffer said. "So rather than paging a physician, which can take up to 30 minutes, they push a button or pick up a phone, and if I've not already seen the irregular rhythm, I'm clued in within 15 seconds."

"I'm a big fan," said Leo DeFault, referring to the eICU technology. "It's the best thing since sliced bread. My life was saved. How do you convince someone that you're foolish not to use these?"

Walking in Wal-Mart (WMT)

In was on June 26, 2008, that DeFault, then 68, suffered "cardiac death" while taking an exercise walk inside the Wal-Mart across from his house. DeFault hit the floor so hard he cracked his skull and for all intents and purposes was dead. The chances of the retired construction engineer recovering without serious brain damage were slim, according to Shaffer.

But DeFault was fortunate to wind up at Palm Bay Hospital just a few minutes away from the Wal-Mart. That hospital, part of the Health First healthcare system, had an eICU remote communications cart. On the cart was a two-way camera, a high-definition computer monitor and LAN-connected health monitoring equipment that allowed Shaffer, who was located in Health First's VitalWatch eICU, to assess the situation and direct ER physicians through what was for them an unfamiliar therapeutic hypothermia procedure.

A single eICU staffed by one critical care physician and two nurses can effectively keep tabs on up to 120 patients. That's because special software, called eCareManager, monitors each patient's vital signs, providing "smart" alerts about any health-threatening changes.

Philips Healthcare said its customers are already using the eICU model to bring telehealth support to the emergency room, the surgical floor and long-term acute care facilities. Others are looking at extending telehealth support to skilled nursing facilities and even into a patient's home.

"If a heart rate changes 15 beats in a three-hour period for a particular patient, that may send up an alert for the physician or nurse," said Frank Sample, CEO of the Philips (PHG) tele-ICU system. "The monitoring software offers a one-page thumbnail graphic for heart rate, blood count and all the other vital signs as they're actually happening."

A patient dashboard

If a patient's health moves in wrong direction, eICU physicians and nurses can bring up a profile page and dig deeper into the patient's health history to determine the cause of the problem. At that time, physicians will typically turn on the remote camera and begin watching the patient and conversing with nurses on scene.


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