By: Ankur Gupta, MS1
A study published last week by the Journal of the American Medical Association shows that patients in the ICU of UMass Memorial Medical Center had significantly reduced mortality rate (8.6% as compared to 10.7%) when they were monitored by a remote “eICU.”
While there have been many studies conducted on eICUs previously, this is the first one to show a significant improvement in patient outcome. In theory, eICUs add another layer of care onto traditional ICUs – doctors and staff at remote sites can enforce treatment plans, ensure that caregivers followed best practices, and alert staff when alarms were going off.
Essentially they provide another set of eyes and ears in an already busy and stressed ICU, and can do this for multiple facilities. Patrick Muldoon, president of HealthAlliance Hospital argues in favor of eICUs:
Nurses and doctors can’t be with every patient every minute. The eICU is constantly monitoring patients and will spot trouble in between visits. It doesn’t put hands at the bedside, but it’s the next best thing
While these results show the promise of remote and mobile monitoring of ICUs, there are many issues that arise from the study. In addition to the eICU, UMass Memorial concurrently undertook broader quality intiatives, which may account for some of the lower mortality. Further, cost analysis was not part of the study – would it be cheaper and more effective to simply hire more ICU specialists as opposed to setting up an expensive eICU? The study also does not prove the value of telemedicine in rural community hospitals. These places don’t have access to specialists, and would potentially benefit greatly from remote monitoring.
The study does, however, open the doors for further investigation on remote and mobile monitoring of severely ill patients. Every health care professional knows the time is extremely critical in these cases, and mobile monitoring – whether it is on an iPhone, or at a remote center – could truly revolutionize the delivery of urgent care. Telemedicine may not be the ultimate solution by itself, but it will no doubt play a big role. Look for more in-depth studies in the near future exploring its efficacy.
Source: Boston Globe
Full Text of JAMA Study