New ICU Technology Increases Efficiency of Patient Care
May / June 2005
Intensive care services in the University of Pennsylvania
Health System have become more comprehensive with the implementation
of Penn
E-lert. Physiologic and other data taken at the bedside are
transmitted electronically to a control center, known as
an eICU, where dozens of patients are monitored simultaneously,
by way of computers, cameras and audio monitors, in much
the same way that multiple aircraft are tracked by an air
traffic control system.
Penn E-lert takes a proactive approach to patient care in
its ability to note subtle changes, track trends, and issue
alerts if blood pressure or other vital signs deviate from
acceptable levels. The technology is a product of Baltimore,
MD-based VISICU, founded by two intensive care specialists,
who recognized the synergies of telemedicine and intensive
care. “The VISICU model is a way of using state-of-the-art
communications and computing tools to enhance the care of
the most critically ill patients in hospitals,” says
C.
William Hanson III, MD, professor of anesthesiology at
the Hospital of the University of Pennsylvania and medical
director for Penn E-lert.
The intensivists and nurses who man Penn E-lert’s
command center monitor patients at both Pennsylvania Hospital
and the Hospital of the University of Pennsylvania. Currently,
the system is employed from 6 pm until 7 am. “We look
at nighttime as a vulnerable period when fewer physicians
are in the ICU, yet patients may still become sick,” says
Dr. Hanson. “We have a ‘smart alert’ generator
that looks at the information coming in and raises flags
when something is potentially problematic, such as blood
pressure dropping, a troublesome lab study or a patient attempting
to get out of bed.”
When a flag is raised, the eICU staff analyzes the information
and can see and/or listen to the patient using a camera installed
by the bed. These monitors do not run continuously like security
monitors. Rather, bedside “visits” are conducted
when necessary and can be announced by ringing a virtual
doorbell, indicating the camera is on. Residents and others
at the bedside can use the system for on-the-spot consults
with the intensivist on duty in the Penn E-lert command center.
The intensivist can use the system to summon live personnel
to the bedside when necessary.
Most families, according to Dr. Hanson, have been delighted
with this additional coverage capability and do not see it
as an intrusion. Importantly, the equipment does not replace
human touch but supplements it. “No one has been displaced
by this technology to date in any location,” says Dr.
Hanson. “That’s not part of the plan. This system
improves patient care. By helping to avoid complications,
the system may enable patients to have shorter stays in the
ICU. We absolutely need to find these sorts of tools that
enhance the quality and efficiency of care at the bedside.”
To learn more, visit the Penn E-lert eICU® web site >>
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