How EICU helps hospitals deal with coronavirus overload

Wink and you think Nurse Clark Worth is the air traffic controller. He wore a headset as he sat in front of six giant monitors glowing with alerts and colorful moving charts.

Blink again – as Wooth zooms COVID-19 Patient on a respirator – and you’ll be transported to the hospital’s ICU bed. You can give the smallest details, such as the texture of the patient’s blanket and the pads placed on her pressure point when she is turned into a potential position to help increase the amount of oxygen oxygen in the lungs.

In San Francisco, in two electronics of the Sutter Health Medical System, Wurth has taken care of the patient, a woman in the late 40’s in intensive care units, or eICUs, in acute respiratory failure at Sutter Alta Bates Summit Medical Center in Berkeley, California.

It can monitor a patient’s vitiligo, check the medications she is taking, and view her ventilator settings without putting on personal protective devices, saving the necessary face masks for all California office fee workers due to the epidemic. The telemonitoring installation includes interactive video and remote diagnostic tools that can access any serious change in the patient’s condition – and immediately alert the root. Bedside, there is a button to push for immediate EICU assistance.

“How does a nurse monitor 50 patients at a time?” The complex-care doctor asks Dr. Shamas, who is sharing the shift with Worth in the late morning of July. “The answer is, they have help,” he replies, signaling the telemonitoring system.

Shougness, who will be longtime medical director at Sugar Health Bay Area EICU, says the program’s goal hasn’t changed much since the early days of 2004: it ensures the sickest patients in both rural and urban hospitals. Geographically, various methods provide access to specially trained nurses and doctors 24 hours a day.

But Covid – 19 – a disease caused by the coronavirus and a long-standing number of patients in the ICU – forced Shugh Ganes and his colleagues to think creatively to reach that goal. In fact, the coronavirus has pushed Large-scale medical industry, to quickly adopt telemedicine, And technology that was mostly already in place. In a possible COVID-19 the shooter’s answer was strategically placed on stands or carts in the form of an iPad that could be used in a converted ICU room.

Typically, between San Francisco and Sacramento EICU hubs, Sutter can care for 395 patients in a bed configured with remote-monitoring installations at its 18 hospitals. With the iPad deployment, and in the case of the growth of the Covid-19, it can monitor up to about 600 beds, Shougness says. At the end of August Gust, about two-thirds of the patients observed – about 200 patients – were Covid-19. It was a pinnacle for the hospital system.

COVID-19 ‘stress test’

Sutter’s EICU program was the first of its kind on the West Coast, and the first in the U.S. But, other hospitals are quickly claiming to be proving to be a good remedy for the acute shortage of critical care doctors in the UK. The life of an introvert, as they are called, can be tedious, as they work nights and weekends. In particular, “tremendous geographical reach,” said Joseph Cavader, president of the American Telemedicine Association.

“How can I take a tool like an ICU clinician and spread them?” They ask. “Well, technology allows you to do that, and that’s the EICU.”

Philips executive Carsten Russell-Wood, whose company supplies hospital systems such as Sutter through IICU, or TeleIQU remote-monitoring technology, says one of its customers, Emory Healthcare, decided to spread the idea of ​​ICU clinicians around a step and more. Critical care providers assigned by Emory to supervise patients from the EICU of the Royal Perth H Hospital Hospital in Western Australia for the care of patients in Georgia.

“While inspecting patients in Atlanta, all of a sudden, the introspectors had to work during the day in Australia,” says Russell-Wood. “You really, ‘Wow, care is nowhere!’ Let’s get into this fantasy! “

And that’s it 5G, the superfast wireless tech that is just beginning to find its place in the world, Will come into play. “In healthcare, what 5G enables is not just improved receptivity and access to data, But it allows that data to be transmitted quickly, “Russell-Wood adds. He also sees an EICU nurse like Wooth, as a type of air traffic controller, enabling more seamless communication with 5G, critical care pilots.

“Finally, 5g It affects the end point more than it affects the infrastructure system, ”says Russell-Wood.

Dr Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, added that EICUs and telemedicine generally “preceded epidemics”. But Covid-19, along with its infection control issues, “is a particularly serious illness that can lend itself well to EICU as we try to limit how many providers go into the room.” The EICU does not replace bedside staff, but can be supplemented by keeping trained individualists physically away from potentially infectious patients, he added.

Dr. Adam Sewer, longtime medical director for Sutter’s Sacramento EICU hub and also working for Phillips, says Sutter’s program has gone through three phases. The first, in the early 2000s, was a phase of discovery in which bedside providers were to play the role of EICU. For urban hospitals, it was a complementary service, another set of eyes. But in small, remote hospitals, where 24/7 ICU staff was not practical or affordable, the EICU filled a crucial void. Sever says that the second phase, everyone settled into their established EICU role.

COVID-19 was introduced in the third phase, when EICU “became an essential component of being able to respond to surgeons,” he adds. With Covid, “People discovered that the ability to access people applies not only from 300 miles away … but also from five feet away. We can use our software to keep the room out of reach.”

Russell-Wood of Philips adds, COVID-19 has pushed patients and clinicians to see the benefits of remote monitoring. “I think what we’ve seen is that every standard of care is being reconsidered with the concept of stress-testing.”

Indeed, in August Gust the Centers for Disease Control published guidelines for health care providers to use telehealth to expand services during the COVID-19 epidemic, highlighting improved patient health outcomes as a potential benefit.

Tech support

If you ask Shagness and Bay Area EICU Operations Director Lisa Ochoa what innovation has been the most transformative for their program, the answer is obvious: electronic health records, or EHRs, a digital format that collects patient health information that can make a variety of health Can be shared in care settings. EHR adoption was accelerated by a 2009 law that provided financial incentives, and most hospitals adopted them by 2015.

Shagnes recalls days before AHR, when hospitals had “rooms filled with file cabinets”. He says those days were “like driving a sports car in first gear.” With EHR, he says, productivity has tripled.

Cavadar agrees that electronic records have been heavily impacted, but it offers better bandwidth, high-definition cameras and more like everyday consumer opportunity. How cheap LCD has become.

“There’s no jumping into a particular space that has helped us do this 1,000 times differently.” “It’s just slowly becoming less expensive, more connected and more powerful.”

Video chat products like FaceTime of Chat Moment, along with Wi-Fi improvements, have also become key in creating temporary EICU rooms and getting closeups on the wound – although Saver says he generally prefers to fix the fixed camera on the wall. A nurse.

But the real strength of EICU, Sewer explains, is its role as a “central cognitive clearing house”. Especially for something like a novel virus, where there’s a lot of speculation and new information that needs to be learned on the fly, “whether it’s a way to quickly standardize or at least a way to approach for probability or not spread quickly.” Says. One example Sever mentions is spreading the word about the pronunciation technique Berkeley used on a patient with respiratory failure.

Speaking of EICU software, Russell-Wood says Philips is constantly adding smart algorithms and AI-enabled devices to leverage medical data so that clinicians can make informed decisions. Predictive analyzes allow clinicians to be proactive rather than reactive, he adds. “You can really predict adverse events by recognizing the adverse trends that the system tells you to tell.”

Of course, it comes with technical costs – and the EICU is expensive: an article in the Permanent Journal estimates that it costs between 2 2 million and 5 5 million to build a “command center” for just one EICU. The article also estimates initial costs between 50,000 50,000 to ,000 100,000 per bed. Temporary, iPad-enabled EICU beds are much cheaper. Still, costs are a source of stress.

“For 17 years now when the ECU has been present at Sutter, there has always been constant pressure to demonstrate cost-effectiveness,” says Sever.

And it is almost impossible to measure the success of the EICU, he added, despite many efforts. Figures from Sutter and Phillips show how the EICU has shortened the length of ICU stay, reduced operational costs per patient stay, and reduced mortality.

Or you can simply take care of a Covid-19 patient. She is out of ICU and is recovering nicely.

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The information contained in this article is for educational and informative purposes only and is not intended as health or medical advice. Always consult a physician or other qualified healthcare provider about any questions you may have about a medical condition or health objectives.