Akademik

n.

A medical support center that enables doctors to monitor, diagnose, and suggest treatment for ICU patients from a remote location.

Swedish Medical is one of a growing number of hospitals opting for a radical form of outsourcing by using technology and doctors stationed off-site to monitor the well-being of critically ill patients. Instead of listening through a stethoscope, a single doctor can track multiple patients at all three hospitals from a remote facility by watching monitors and Webcams, working from a post that looks a lot like an air-traffic controller's station. And not only do patients rest easier without the predawn interruptions, they're actually getting better medical care, says Swedish Medical president Rodney Hochman. "They love having the watchful eye looking over them all the time," he says.

It's the latest way America's overburdened health-care system is trying to adapt to an era in which there are too many patients, too few doctors and too little insurance money to pay for treatments. Remote ICU centers, in which critical-care doctors (called intensivists) and nurses watch patients from afar, can save lives and money, according to Visicu, the Baltimore firm that developed the concept. The firm's eICU, developed by former Johns Hopkins intensivists Brian Rosenfeld and Michael J. Breslow, is now used by 40 hospital systems to monitor roughly 4,800 beds. "In five years, this will be the accepted standard of care for patients in this country," says Rosenfeld.

—Linda Stern, "Care From Afar," Newsweek, September 17, 2007

Lilly is an intensive care specialist, but he was seated not in the intensive care unit, and for that matter, not even in Sisler's hospital. Rather, he was working out of a low-rise office building in downtown Worcester — 3 miles from where Sisler lay at Umass Memorial Medical Center.

From this carpeted, fluorescent-lit support center, called an "eICU," Lilly and nurse practitioner Joanne Lewis were supervising the care of 109 of Umass Memorial's sickest patients, scattered among eight ICUs at three of the system's hospitals. They are part of a new program that aims to cope with the soaring number of ICU patients, a problem exacerbated by a shortage of intensive care specialists.

There are 20 percent more ICU beds nationwide now than there were 10 years ago, and too few doctors trained to care for the patients filling them. The vast majority of hospitals do not have an ICU specialists working at night or on weekends, despite studies showing that when intensive care doctors manage or help manage ICU patients, the patients' chances of dying in the hospital decrease by 30 percent.

Umass Memorial Health Care is the first hospital network in Massachusetts to build an eICU, which it opened in February; there are about 40 nationally.

The emergence of eICUs shows that so-called "telemedicine" has reached a point where specialists trust it enough to make real-time treatment decisions for the sickest patients.

—Liz Kowalczyk, "Tele-treatment: Monitoring from afar, 'eICUs' fill medical gap," The Boston Globe, November 19, 2007

Under the deal signed yesterday, intensivists at Sentara Healthcare in Norfolk will still staff their ICUs the old fashioned way in the morning. But each of the specialists will also spend a few nights a month at an electronic command center — an " EICU" — supervising patients during hours when there is no intensivist on the unit.

The doctor in the EICU, which is in an office park in Norfolk, will monitor all three ICUs and will be assisted by a nurse, a clerk and a technical support person.

—M. William Salganik, "Telemedicine business is launched by 2 doctors," The Baltimore Sun, April 6, 2000