An Electronic Intensive Care Unit (eICU) is a form of telemedicine that uses state of the art technology to provide an additional layer of critical care service. An eICU may also be referred to as a tele-ICU.
In India, each year, an estimated 10 percent of all hospital admissions require ICU care. The statistics are staggering- just 70,000 well equipped ICU beds against an estimated demand of 400,000 ICU beds to provide critical care for approximately five million ICU cases per year. It is equally alarming to see the non-availability of qualified intensive care specialists. Only 6000 intensivists are catering to the critical care needs of five million patients!
An eICU support center can provide care to patients in multiple hospitals. The goal of an eICU initiative is to optimize clinical expertise and facilitate 24-hour-a-day care by ICU caregivers, whether the caregivers are down the hall from the patient that’s being monitored or in another city.
Two-way cameras, video monitors, microphones and smart alarms connected by high speed data lines provide eICU caregivers, who are called intensivists, with real-time patient data around the clock. Intensivists can also communicate with on-site caregivers through dedicated telephone lines.
The technology infrastructure provides medical personnel with the ability to track outcomes, both for individual patients and for the medical facility that runs the eICU.
In the United States, more than 300 hospitals in more than 40 health systems across 34 states take advantage of eICU services. Adoption levels are lower in rural areas but that number is expected to rise as rural health care customers get access to high-speed Internet service.
Rescuing remote patients
In medicine, one never has as many super-specialists, specialists or doctors as they need. At any point of time, the demand exceeds supply in the healthcare industry, especially when it comes to medical professionals. Often, even when the equipment is state-of-art, there are not enough trained personnel to serve patients.
The eICU enables a remote hospital to provide advanced consultation, care and monitoring to their critically ill in-patients without having to physically transfer them to super-specialty hospitals. Transporting a critically ill patient from one facility to another, especially a distant hospital, can be risky. Patients are at risk of clinical deterioration that may lead to adverse events including threat to life, due to the stress caused by transportation. However, eICU helps provide expert care to the patient at the local hospital helping avoid inert-hospital transfer and risks. ICU care at local hospital allows patient get better support from family as well as help reduce costs by shortening the stay in ICU.. Remote ICU Monitoring Technology combined with expert set of eyes can help reduce medical errors and infection within ICUs leading to reduction in patients mortality by upto 60percent.
eICU is a solution to bridge the huge gap of ICU beds by providing specialist care at the point, where it is needed in a cost effective way. It also provides successful evidence based outcomes helping standardize the critical care for the patients irrespective of where they live. Intensivist –led care 24/7 has become a necessity, not a luxury, and this innovation is the only identified way to address the growing critical-care crisis resulting from aging baby boomers and the shortage of critical-care doctors and nurses. The numbers are compelling. Patients conditions in the ICU can change in a matter of minutes, and the doctors owe it to patients and their families to deliver the highest-quality care around the clock, seven days a week.
For India-Road ahead
The patterns of medical problems seen in Indian ICUs are dissimilar to those seen elsewhere. There also change with the categories of the hospital. A number of tropical infections such as malaria, leptospirosis, tuberculosis, salmonellosis, etc. form a significant proportion of the patients. Polytrauma also ranks high in the occupancy charts.
Studies of healthcare systems that have implemented an eICU control center show a 27-percent reduction in mortality rate and a 17-percent reduction in length of stay, primarily because patients are being watched more closely and with quicker interventions. Patients time spent on ventilators has also shown to be reduced.
Critical care in India is at the crossroads of development. The beginnings have been made but there is still a long way to go. The field is full of lot dynamism, opportunity and challenges. One hopes that all the efforts will lead to a humane, scientific and meaningful service for the multitude of critically ill patients.