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Doctors use 'remote control' to monitor ICU patients

Dr. Gene Burke monitors patients in the intensive care unit from a remote station equipped with computers, cameras and health monitors

NORFOLK, Virginia (CNN) -- A Baltimore-based company is aiming to boost hospital critical-care staff efficiency with high-tech help.

Last week, IC-USA began operating the first 24-hour remote monitoring and intervention service in the United States for intensive-care units at two Sentara Healthcare hospitals here. A 16-bed unit at a third Sentara facility is scheduled to join the system in September.

"I can tell you, when I ran my intensive-care unit, my patients didn't have access to me 24 hours a day, seven days a week," said Dr. Brian Rosenfeld, a former Johns Hopkins University Medical Center critical-care unit manager and co-founder of IC-USA. "This is clearly a quantum leap in care delivery for patients in the intensive-care unit."

The company provides critical-care teams made up of a doctor, nurse and administrator, who monitor hospitalized patients from a remote office location equipped with real-time video and live data feeds from digital cameras and monitoring systems in the client hospital.

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This 24-hour coverage is particularly valuable through night and weekend shifts, when many regular intensive-care physicians may be on call, but not in the hospital. IC-USA teams can provide moment-to-moment advice to nurses and other caregivers who otherwise would have to wait for an on-call physician to return a page.

The goal is to identify potential problems and treat them early, before a crisis.

A 1997 pilot study of the system at a Baltimore-area hospital resulted in a 60 percent decrease in mortality, a 40 percent decrease in complications, a 30 percent decrease in ICU length of stay and a 28 percent reduction in health care costs, according to IC-USA.

"What this lets us do is leverage what is really a very limited resource," said Dr. Rod Hochman, a senior vice president and chief medical officer at Sentara. But, he said, "I need to emphasize that there's nothing like the personal touch -- being next to a patient and talking to a patient face to face."

Less than a third of U.S. hospitals currently have qualified intensive-care specialists on hand, according to the Society of Critical Care Medicine.

Rosenfeld said using remote intensive care may be the only way to spread the expertise around.

"So I can attend a patient here, and I can attend to a patient 25 miles away by doing nothing more than moving the (computer's) mouse," said Dr. Gene Burke, a Sentara intensive-care specialist who is working under contract with IC-USA.

IC-USA care teams are briefed on each patient in the unit, and detailed medical records are available by computer.

"My patient dropped her blood pressure and we hung fluids and started drips that we needed to implement, bringing her pressure back up, and they (the remote team) were able to see it the same time that I did," said intensive-care nurse Sheila Foote.

"When you really care for someone, you want someone to watch over them constantly and be able to move the minute something happens," added intensive-care nurse Lisa Curling.

Tens of thousands of U.S. patients die each year from avoidable complications, according to Rosenfeld. IC-USA's system is designed to reduce errors. For example, records are typed to avoid mistakes in interpreting notoriously difficult physician handwriting.

"We don't have to deal with ... 'What do you think this word is? Well, if I look at it upside down, maybe we can figure it out,'" said Foote.

In addition, the system can provide suggestions on proven treatment guidelines for certain medical conditions.

Still, IC-USA's remote doctoring is best used to augment hospital staffs, not replace them, administrators note. The new service costs from $800,000 to $1 million a year, but Hochman estimated that it should pay for itself in saved costs within about three years.

CNN Science Correspondent Ann Kellan contributed to this report.

Society of Critical Care Medicine
IC-USA
Sentara Healthcare

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