Photo: Philips
24 May 2011—According to doctors at the University of Massachusetts Medical Center in Worcester, intensive care units backed up by off-site doctors and nurses, who could remotely monitor critically ill patients and direct the ICU’s on-site staff, had fewer patient deaths and shorter ICU stays. Their trial of a so-called tele-ICU system, which allows intensive care specialists outside the hospital to see and hear patients, monitor vital signs, and access medical records, proves that such a system actually benefits patients.
Over the two-and-a-half-year study, off-site doctors and nurses manned multimonitor computer stations from a nearby building, where they received real-time information on patients. The UMass tele-ICU system is based on Philips’ Visicu eICU technology. The system’s software can detect trends that lead to patient deterioration. Off-site teams could verify these trends and, using microphones and cameras in each ICU room, collaborate with bedside nurses and physicians to treat the underlying causes.
The study’s results associate the use of tele-ICUs with lower mortality rates, shorter hospital and ICU stays, and lower rates of preventable complications. According to the findings, which were published last week in the Journal of the American Medical Association, the ICU mortality rate was 10.7 percent before tele-ICUs were introduced, compared with 8.6 percent afterward, and the mean length of an ICU stay was 6.4 days before tele-ICUs were used and 4.5 days after they were introduced. Before the tele-ICU experiment began, 13 percent of patients developed ventilator-associated pneumonia, but during the tele-ICU trial, only 1.6 percent experienced that preventable complication.
Craig Lilly, who led the UMass team, says that the success at UMass would be hard to translate to all ICUs. The academic medical center setting was a good backdrop for coordinating an effective program, and executive support also helped to integrate the technology into the staff workflow, he says. That was important, because the system "isn’t really about the computer but rather the interaction between the physical technology and the people at the bedside." The complex eICU technology is ultimately intended to enable better, more-efficient teamwork, he says.