"It creates a sense of collaboration," Sample said.
For example, if a patient goes into cardiac arrest and a nurse performs CPR, the eICU physician can monitor an electrocardiogram readout and the calibration off a ventilator to determine the effectiveness of the procedure.
Each eICU command center has five to six computer-monitor workstations that can keep track of multiple patients. Doctors and specially trained ICU medical personnel in the command center can speak with the remote ICU personnel to discuss clinical patient data and can view televised images of the patients. Direct patient care is provided by the doctors and nurses in the physical ICU, who do not have to be specially trained in intensive care procedures.
That last point is important because in recent years, the number of people needing ICU care has gone up -- without a corresponding increase in the supply of professionals trained in ICU techniques.
About 300 hospitals in 40 healthcare systems across 30 states now use eICUs. As a result, more than 300,000 patients are remotely monitored by eICUs each year -- about 10% of U.S. adult ICU patients, according to Philips. And the popularity of eICUs is growing. Last year, another 500 beds were added nationwide.
Philips provides the professional services to set up the eICUs along with the health monitoring software. The hospitals are responsible for purchasing all the hardware and finding a suitable facility with networking connectivity in which to run the eICUs.
The eICU software alone costs from $2 million to $3 million.
Expensive, but worth it
However, the cost is well worth it, according to Shaffer. Health First's VitalWatch has saved lives and money, and the patient litigation rate has dropped to zero since the hospital installed the eICU system seven years ago. "All it takes is one legal bogie, and you're talking a couple millions dollars," he said, referring to potential damages that could be awarded in a lawsuit.
The remote monitoring facility has also helped reduce the number of sepsis cases, a major problem among U.S. hospitals, as well as the amount of time patients spend on ventilators, Shaffer said. "It's not unusual for patients with sepsis to present at night when there are few physicians around," he said.
DeFault said that even if he had been taken directly to a state-of-the-art hospital in a major city, he'd still want it to have an eICU.
"If someone has a heart attack on the 24th floor, by the time you get them down to the 17th floor where they can be treated, they're gone," he said. "It was instrumental in me having lived my second life. I don't know how else to praise it."
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