Kaleida ICU patients get dose of telemedicine December 15th, 2003 BY ANNEMARIE FRANCZYK Patients in the intensive care units at Kaleida Health hospitals are about to have their conditions monitored from afar with a telemedicine system that is gaining recognition for improving care and decreasing costs. The eICU® program is expected to augment and enhance, not replace, the work of the doctors and nurses who are on-site with the ICU patients, said Dr. Cynthia Ambres, Kaleida's chief medical officer. Developed by two intensive care specialists in Baltimore, the eICU® program connects each of the intensive care rooms at the health system's four adult-care hospitals via computer to a remote monitoring site. The doctor, nurse and data specialist staffing the site will keep an eye out for changes in patients' status and alert the ICU staff by phone. The monitoring staff also can elect to watch the hospital staff respond through cameras mounted in each ICU room. The system spreads doctors' expertise to more patients across the ICU units. The extra set of eyes will be a welcomed addition to the intensive care units where extremely ill patients often require constant attention from the medical and nursing staff, Ambres said. "These people are very complex and very very ill and they require tremendous amounts of time and equipment. eICU® is like having someone in the room all the time," Ambres said. A 2001 independent Cap-Gemini, Ernst & Young study showed that the eICU® program has reduced mortality by 25 percent and lowers per-patient costs by $2,150. The study also showed a 17 percent reduction in the number of days patients stay in the ICU. The eICU® system is in use or being installed at nine multi-hospital health systems from Virginia to Hawaii. It will be installed to monitor all 72 ICU beds in Kaleida, beginning in about six months at Buffalo General Hospital and over the following eight months at Millard Fillmore hospitals in Buffalo and Amherst and DeGraff Memorial Hospital in North Tonawanda. Purchase price was not disclosed, but Ambres said costs include software, set up, cameras and some computers and monitors. Kaleida will make some room in administrative space it is taking in the Larkin at Exchange Building for the monitoring site, and hire staff for the site, Ambres said. The eICU® system is a product of Visicu Inc., founded in 1998 by two intensivists, physicians who specialize in critical care patients. Studies have demonstrated that intensivist involvement in the care of ICU patients helps prevent complications, leading to double-digit improvements in patient outcomes. In 2000, the Leapfrog Group, a patient safety initiative representing Fortune 500 companies, called for full-time intensivist staffing as a way of saving more than 50,000 lives per year. Less than 6,000 are actively practicing in the United States, leaving only 13 percent of ICU patients receiving dedicated intensivist care, according to Visicu. Pulmonologist Dr. Susan Schwartz, chief of medicine at Kaleida, said she is optimistic about the eICU®. She said the new system has potential to track a patients' history. A pulse rate bumping up from 80 to 92 might not be significant as a single event, but pulse rates tracked over time could help detect a pattern and better predict the patient's medical care, she said. "It picks up early signs that might not otherwise be picked up," she said. Further, the system can reduce doctor burn out, caused by the intensity of the care required and the round-the-clock nature of caring for ICU patients, according to Ambres and Schwartz. Doctors are often called three or four times overnight regarding changes in patient status, something the remote monitoring should decrease, Schwartz said. "For the nurses this is a godsend because there's always someone to speak to. The fact that someone else is watching would be very reassuring," Schwartz said.