The eICU care model sets the stage for systematic changes in ICU care. An intensivist-led eICU-based care team located apart from the hospital, partners with on-site ICU clinicians. The eICU center does not house patients or replace the hospital ICU. It operates like an air traffic control center providing remote or after-hour support. Experienced specialty physicians and critical care nurses are networked to multiple ICU patients across a health system by voice, video, and data. eICU physicians and nurses execute predefined plans or intervene in emergencies when a patient’s attending physician is not in the ICU. Proprietary technology used in the ICU improves physician workflow and enables clear communication between the ICU and eICU center. The technology incorporates 2-way video and “cockpit-like sensors” that enable the eICU staff to communicate more effectively with the bedside team to reduce the time between problem identification and intervention. Software tools include:
Care interventions occur earlier because monitored patient information is processed through VISICU’s proprietary Smart Alerts software, which evaluates trends in patient physiologic and laboratory data. Software prompts indicate when a patient is straying “out of bounds,” (e.g. early sepsis) enabling the eICU physician to intervene, often precluding an adverse event.
Tools are provided to capture all patient data in one place for ease of documentation, reporting, and reference. Multi-professional care teams are able to reference a complete profile of the patient and their care for improved assessment and treatment. Clinical efficiency is improved through automatic recording of vital signs data, interfacing to lab systems, and support of the eICU staff to capture much of the scheduled documentation requirements through virtual rounds. With less time spent running for the data, more time can be spent on what they do best – caring for the patient.
Standards of care are maintained and often improved because clinicians have on-line access to the VISICU evidence-based care guidelines. A comprehensive and interactive on-line decision support tool called The Source, supports algorithm-driven interventions for diagnosis and treatment. Care recommendations are regularly updated using evidence-based medicine, society guidelines, and input from an international panel of experts.
Clinical outcomes, resource utilization, and operational efficiency are tied to the Agency for Healthcare Research & Quality (AHRQ) recommendations and are regularly tracked with VISICU’s Reporting Solutions. Daily management tools enable real-time patient-specific analysis for compliance with best practices. Ad hoc queries can be customized to facilitate ongoing research.
The sophisticated eCareManager™ software enables seamless integration between ICU and eICU care providers while supporting patient information flow during hand-off points between nurse and physician, at shift changes, and during transfer to different physical locations. The applications are presented in a dashboard-style user interface for fast clinical analysis of a patient’s condition and a quick review of assigned tasks.