Remote Electronic System Improves Care for ICU Patients

Intensive care units (ICUs) are the ultimate in high-stress work situations.

The patients in ICUs are typically in extreme pain or even in danger of death as they recover from operations or traumas. The nurses and doctors responsible for bedside care must take care of the immediate needs of their patients while simultaneously monitoring a host of complicated monitors that show the patients' vital signs.

But a medical innovation known as the Electronic Intensive Care Unit (eICU) provides a constant flow of information to help nurses and doctors make important decisions about patient care. The eICU has been operating since October at Froedtert Hospital in Wauwatosa. "The Electronic ICU provides the bedside staff with an extra level of support, an extra level of eyes and ears," explains Joseph James (Jay) Hine, MD, Medical Director of the eICU and Assistant Professor of Pulmonary/Critical Care Medicine at the Medical College of Wisconsin.

Constant Care
The Electronic ICU is located in a futuristic room where a team of veteran critical-care nurses, each with a minimum of five years' experience in ICU settings, watch a set of monitors for such crucial indicators as blood pressure, heart rate, oxygen levels, and respiratory rate.

"The nurses function a bit like air-traffic controllers, staying alert and bringing any vital information to a doctor's attention," Dr. Hine says. "They are our front-line people. They let us know when the bedside nurses and doctors need some assistance."

In addition, the Electronic ICU is connected to video cameras that allow the eICU nurses to look directly in on patients. Customarily, ICU nurses are assigned two patients. "If a nurse has to see the other patient, all they have do is hit a button and communicate with the Electronic ICU so that the patient can be constantly watched," Dr. Hine notes.

"The basic goal is to improve patient care by providing as intense coverage as possible," he says. "The eICU supports the bedside staff 24 hours a day. This is real-time support, because the ICU nurses can pull up data and assess the patients virtually.

Moreover, the eICU plays a crucial role by watching out for "trend data," monitoring almost imperceptible changes in, say, a patient's oxygen level or blood pressure over time. "With the eICU, we can pick up trends early and reverse them before a life-threatening emergency occurs.

Partnerships Help Us Reach More Patients
Last October, Froedtert launched the Electronic ICU covering a total of five ICU units across the state, including Thedacare in Appleton, Bellin Hospital in Green Bay, and Froedtert for cardiac, surgical, and medical ICU units. Sometime around August, Community Memorial Hospital will be hooked into the eICU system. "We're the first system in the US to implement a virtual ICU with a partnership of hospitals," says Dr. Hine.

The eICU at Froedtert currently covers 108 ICU beds at the five locations. After Community Memorial comes on board, it will cover 129 beds. The present capacity of the eICU system is 300 beds.

We're seeking to add about two more ICU's a year," says Dr. Hine. "Along with Community Memorial, we have some preliminary discussions going with other hospitals.

The partnership with other hospitals strengthens the eICU's operations, Dr. Hine believes. "First, we have integrated the patients' medical records. Second, we share experience and knowledge among all the hospital systems.

"Instead of sticking with the mindset of one hospital system, there is a sharing of the resources and perspectives of three hospital systems. It opens people minds to different ways of thinking. I think it creates a process for changing things."

As Dr. Hine sees it, the eICU has just begun to scratch the surface of its potential. "We are looking forward to innovations and meeting more day-to-day needs through new applications. I think as we develop our software, we will be able to implement even more efficiencies and better serve ICU patients."

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.