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Providing 'Round-the-Clock Care

New Technology Coming to Inova

An extra set of eyes will be monitoring intensive-care patients in the Inova Health System's hospitals beginning this fall.

The eICU technology will provide 24-hour monitoring of critical-care patients through "virtual rounds" that can detect the slightest change in a patient's condition and alert the Intensive Care Unit (ICU) staff before the patient enters a crisis situation.

"It's a very intensive patient monitoring system that adjuncts to what we do now," said Dr. William Hazel, an orthopedic surgeon at Inova Fair Oaks Hospital. "Now, patients are monitored normally on site. … With electronic ICU (eICU), all patients connect to a central location with a team of nurses, doctors and other staff. There is constant monitoring."

THE EICU is a network of work stations, each station consisting of four monitors: one to monitor a patient through a digital camera, one for monitoring vital signs, one is the smart alert and the fourth does all the reporting, located in what Hazel called "the box," which could be located off hospital property.

All four Inova hospitals: Alexandria, Fair Oaks, Mount Vernon and Fairfax, will eventually tie into one "box," which will be staffed by Inova personnel. The eICU will be phased in, with Fair Oaks mostly likely being the first to receive the new technology. The eICU technology, created by VISICU based in Baltimore, Md., is already being used by 14 health systems across the country.

"In a typical ICU, there are critical-care nurses 24-7, however, physicians are not there 24-7," said Cheryl Isen, spokesperson for VISICU. "When a patient moves into a critical situation, he or she typically does so rapidly. The nurse would have to call the right physician on the phone. The nurse would be tracking down the physician before an intervention takes place … while this happens, critical minutes are ticking away."

WITH THE EICU TECHNOLOGY, a team consisting of critical-care specialists, including a physician, could communicate with the on-site critical-care nurse and order the intervention of the patient before the attending physician arrives. Isen said one eICU facility can monitor up to 200 patients.

"The team has real-time medical information and a camera in the patient's room that is so advanced it could do a pupil check," Isen said.

The team would have access to a patient's real-time vital signs, any laboratory reports, medical history, medication and test results. The technology could also alert the team if there is a slight change in the patient that could lead to a critical-care situation, which allows the on-site staff to intervene sooner.

According to Inova, a study published in the "Journal of Critical Care Medicine," concluded the eICU system reduces patient mortality by as much as 25 percent and decreases patient days in the ICU by 17 percent.

"IT GIVES a physician a back up," said Hazel. "It's a lot tighter monitoring."

Hazel said a patient admitted to the ICU should not notice anything different. The eICU does not require any additional equipment as far as the patient is concerned. Each room will be outfitted with a camera and two-way communication device, however, for privacy reasons the camera will not operate around the clock. Periodically the eICU team will turn the camera on to monitor a patient. A sound similar to a doorbell as well as the physician using a communication system will alert the patient the camera is being turned on. If on-site medical staff or family is in the room, they can request the camera not be turned on at that particular time.

Hazel said the additional technology will require training for the staff of "the box," however, details are still being worked out where it will be located.

Hazel said if the technology works as well for Inova as it has for other health-care systems, it should assist staff in providing better patient care. He also said it allows on-site staff to spend more time with the patients, because it automatically does some of the paperwork now required of staff.

"It enables someone to be there 100 percent of the time," Hazel said.