While the faces in tomorrow's hospitals will be the same, doctors and nurses will be armed with a brand new set of high-tech tools designed to bring additional layers of expertise and safety to the patients they care for. Among the new initiatives, Sutter Health will be the first on the West Coast to use technology from Baltimore, Maryland-based Visicu Inc., to provide physician specialists with tools that will enable them to keep an even closer eye on critical care patients 24 hours a day, seven days a week.
The solution uses telemedicine technology, early warning software with advanced video and electronic monitoring, to connect off-site critical care specialists to ICU patients. The eICU is a centralised, remote patient management centre which connects intensivists to patients in multiple ICUs. The eICU is staffed around-the-clock by intensivists and critical care nurses who provide patient oversight when the attending physician is away from the bedside. The contract initially calls for an eICU in Sacramento to be linked to 94 ICU beds from multiple hospitals in the region. This will be followed by two additional eICUs in the Bay Area connecting to the remaining Sutter hospitals.
In the new wired ICU, vital signs and laboratory data from the sickest hospital patients will be fed to existing on-site doctors and nurse stations as well as to a new, remote, specially equipped electronic ICU (eICU). The additional critical care support team provides another set of watchful eyes, constantly checking early warning indicators for vital sign changes and looking for any sign of trouble.
The challenge has been the nationwide shortage of intensivists. Less than 6000 intensivists are actively practising in the United States. Many communities, especially those in rural areas, do not have access to intensivists at all. Sutter Health's newest initiatives address key goals set by the Leapfrog Group, a national consortium of major employers that is encouraging hospitals to adopt specific practices to improve health care quality and service.
Hospitals within the Sutter Health network will begin applying advanced technology to administering patient medications at the bedside. A computer bar code on each patient's identification bracelet will be used to match and monitor the medication ordered by the doctor. Before administering medications, nurses and other caregivers will scan a bar code imprinted on the patient's armband, and on the medication, using a hand-held device. A bedside computer will then "read" these bar codes into a software application that uses expert databases to provide patient-specific information.
The number of medications has grown 500 percent in the past decade. Today, more than 17.000 trade and generic pharmaceuticals are marketed in North America. This new system helps ensure the right dose of the right medicine is given to the right patient at the right time. It also alerts the clinician to possible allergies, and look-alike/sound-alike or high-risk drugs. Sutter Health has selected the Bridge MedPoint bar code-enabled point-of-care (BPOC) software system, pioneered by Bridge Medical Inc., in Solana Beach, California to provide this advanced safety net for patients and nurses.
The Pacific Business Group on Health (PBGH), a coalition of nearly fifty large California businesses which purchase health care for some three million employees, is leading California's Leapfrog effort to improve the quality and availability of health care. Sutter Health's efforts to improve patient safety and clinical outcomes also include formal, co-ordinated, goal-oriented initiatives to improve patient care. Sutter Health physicians and hospitals have been successful in improving early detection and treatment of breast cancer and in improving the health of patients suffering from congestive heart failure.
Composed of more than 100 public and private organisations that provide health care benefits, the Leapfrog Group works with medical experts throughout the United States to identify problems and propose solutions that it believes will improve hospital systems that could break down and harm patients. Representing about 32 million health care consumers in all 50 states, Leapfrog provides important information and solutions for consumers and health care providers.
Sutter Health is a not-for-profit network of community-based health care providers, delivering high-quality care in more than 100 Northern California communities. Sutter is also the regional leader in infant deliveries, neonatology, orthopaedics, paediatrics and cancer care services. Sutter Health supports more than two dozen locally-run acute care hospitals and physician organisations, as well as medical research facilities, regionwide home health, hospice and occupational health networks, and long-term care centres.
More news on the eICU solution is available in the VMW June 2002 article VISICU's remote ICU service provides full-time electronic coverage to New York Metropolitan area.