Mercy's electronic ICU technology provides enhanced critical patient care

Patients in the intensive care unit of Fort Scott's Mercy Health Center will now be provided with around-the-clock specialized care thanks to Mercy SafeWatch, a telemedicine program that connects the critical care patient rooms to a centralized ICU.

The electronic ICU (eICU) technology, provided by Visicu, Inc., enables off-site critical care physicians and nurses to provide 24-hour support to hospital-based ICU staff through the use of remote voice, video and data monitoring tools and early warning software.

The eICU command center, which houses the off-site specialists, is located in St. Louis, Mo. Through the eICU technology, the specialized physicians, known as intensivists, will be able to monitor patients' vital signs, such as blood pressure, heart rate, etc. Also, should the need arise, the intensivists can enable a camera and actually have a visual of the situation in the ICU unit. By doing so, the specialized physicians and nurses will be able to assist as much as possible with any situation.

"It's an added layer of monitoring for our patients," Mercy ICU Coordinator JoAnn McNutt said.

Mercy President and CEO Ron Ashworth said in a press release that the eICU system is aimed at benefiting Mercy staff, as well as patients.

"Mercy is committed to providing our patients with the safest, high-quality care possible, so combining the strengths of the established intensivist program at St. John's Mercy (in St. Louis) with eICU technology will benefit both our patients and ICU staff across our health system," Ashworth said.

On Visicu's Web site, www.visicu.com, the company likens the eICU system to air traffic controllers.

"An eICU center is staffed with an intensivist-led care team that can monitor and care for hundreds of patients much like air traffic controllers monitor hundreds of planes," the site reads. "In an airplane, pilots also use on board sensors to identify problems and intervene to maintain a safe flight. Likewise, the eICU care team uses software alerts to track patient vital trends and intervene earlier, before complications occur."

Also according to the Web site, studies have shown that eICU system can reduce ICU mortality by 25 percent.

"The keys are constant surveillance, providing the patient with immediate physician access and arming the physician with the patient information needed to make the right decisions quickly," the site reads.

McNutt said that the command center in St. Louis knows who and how many patients are in the ICU at all times.

"They have a list of patient census," she said. "They know everybody that is in here now. We call them if we someone else comes to the unit."

Because of the increased monitoring of the patients, the patients' privacy has been the subject of questions about the new system. McNutt said, however, that certain regulations are in place to protect the patients' privacy, while still providing them with the best care possible.

"We ensure that when we're working with a patient in here, the camera is turned off," she said. "The camera is not on all the time. Only if (the intensivists) come into the room and introduce themselves is the camera on. They can see the monitors and everything from there, like the blood pressure and things like that, but that is tied through he monitor, not the camera. Privacy is of the utmost concern for us here."

No recording is made of any camera or microphone, and Mercy SafeWatch doctors and nurses only view patients when necessary. When the camera is turned off, the lens is turned inward toward the wall. An audible signal, like a doorbell, for example, sounds when the two-way microphone in the room is turned on, allowing for a conversation between Mercy staff and the eICU command center intensivists.

Patient information sent to and from the Mercy SafeWatch center is scrambled as it travels across the data lines, then unscrambled when the information arrives, so that the authorized physicians and nurses can read it.

The eICU system, while providing an additional support level, does not replace the regular bedside physicians and nurses in Mercy's ICU.

The patient's physician is still the ultimate decision-maker in the care provided. However, because the patient's physician and the Mercy SafeWatch team discuss the patient's medical status and treatment plan daily, the intensivist may modify treatment according to the plan when the patient's physician is not present in the hospital.

Staff nurse Susan Woods said that Mercy's patients have welcomed the new eICU system.

"They've been very receptive to it," Woods said. "I have not had anybody tell me they didn't like it. Plus, it's for their benefit."