Swedish is among the first 13 health systems in the country to begin using this technology, which combines telemedicine with advanced software systems. The concept of remotely monitoring ICU patients was developed by two intensivists at the Johns Hopkins School of Medicine who, in 1998, formed VISICU Inc. and produced what is now called the eICU solution. Swedish now has 42 ICU beds on its First Hill campus connected to this system and hopes to begin implementation of the eICU solution at Swedish/Providence in the first quarter of 2005 to monitor another 33 ICU beds.
Each intensive-care room is equipped with a high-resolution video camera, microphone and speaker, allowing intensivists in the monitoring centre to talk with ICU staff and observe details such as a patient's breathing patterns or movement. Critical information, including blood pressure, pulse and heart rhythm for each patient are continually fed in real time to computers in the eICU monitoring room. A database of detailed patient information, including medications, lab results, active diagnoses and therapies is also instantly available to the intensivist staffing the eICU centre. A key feature of the eICU system is the ability to pick up nearly imperceptible changes in a patient's condition or vital signs. Because intensive-care patients are so medically fragile, this "early warning system" helps head off life-threatening complications.
"This is an excellent blend of leading-edge technology and bedside attention", stated Curtis F. Veal Jr., M.D., pulmonary/critical-care specialist and medical director of Swedish's eICU programme. "It's an opportunity for us to take a giant leap forward to help ensure safety of patients in the ICU. The technology has been implemented in sites around the country and there's been marked improvements in outcomes for ICU patients, fewer complications, reduced mortality, reduced length of stay and increased comfort levels for families. The data is compelling."
This new care-delivery model enables optimal use of scarce health care resources while simultaneously improving patient outcomes and financial results for health systems. A study of the eICU system published in Critical Care Medicine (Crit Care Med 2004; 30:31-38) proved the clinical and financial benefits. Physicians and staff at Swedish already feel it's having a positive impact on patient outcomes and it has definitely increased families' comfort level to know their loved ones are being so closely monitored.
"All of this will provide an added layer of patient oversight without removing the in-room care and attention patients and their families need", stated James M. Vincent, M.D., critical-care and pulmonary medicine specialist at Swedish. In 1998, Swedish became the first medical centre in the area to begin having dedicated intensivists on-site from 7 a.m. to 7 p.m., and have physicians "on call" only at night. Now that the new eICU system is being used at Swedish/First Hill, intensivists are available to monitor ICU patients around-the-clock.
"As an organisation driven by quality, we are delighted to be among the first hospitals in the entire country to offer this exciting new technology", stated Richard H. Peterson, president and CEO of Swedish Medical Center. "The eICU system is helping us take patient care to the highest level for our sickest and most fragile patients. Importantly, it also addresses a key priority of The Leapfrog Group."
The Leapfrog Group is an association of large employers including Boeing, that finance health insurance for their employees. It has identified dedicated ICU physician staffing as a priority for improving patient care. With the chronic shortage of intensivists nationwide, only 10 percent to 15 percent of hospitals in the United States are able to provide optimal coverage of their ICUs. By installing the eICU system, Swedish will help alleviate that problem in this region.
"Swedish's implementation of the eICU solution is inspirational proof to large health care purchasers that leveraging or strategic use of information technology in health care can help hurdle health care labour shortages and deliver breakthroughs in patient safety and health care affordability", stated Arnold Milstein, M.D., co-founder of The Leapfrog Group.
Prior to Swedish's initial use of the system on September 8, more than 100 staff members from various departments put in a lot of time and effort over a six-month period to get the job done. The eICU solution system at Swedish cost $2,7 million in initial capital costs, which was generously provided by supporters of the Swedish Medical Center Foundation. Once the system is up and running at Swedish's hospital campuses, annual operational expenses are expected to run about $2 million.
Swedish Medical Center is the largest, most comprehensive, non-profit health provider in the Pacific Northwest. Swedish is comprised of three hospital campuses - First Hill, Providence and Ballard, Swedish Home Care Services and Swedish Physicians - a network of 11 primary-care clinics. In addition to general medical and surgical care, Swedish is known as a regional referral centre, providing specialized treatment in areas such as cardiac care, oncology, orthopedics, high-risk obstetrics, neurological care, sleep medicine, paediatrics, organ transplantation and clinical research.
More information is available in the VMW March 2004 article Swedish Medical Center is first to offer eICU care in the Northwest of the United States. More on VISICU's eICU system is available in this VMW issue's article Visicu's innovative life saving eICU solution awarded United States patent.