Tele-ICU

There is a dearth of definitive studies on conducting healthcare delivery via electronic ICU (PICU) and evaluating the best way to interface with a computer system in order to obtain the maximal benefit. Current studies are observational at best and replete with multiple methodological problems. The work of ICU staff is complex, requiring multitasking and complex analysis combined with negotiating skills to enact action at the patient’s bedside. During standard operations, the eICU system collects data from the patient’s bedside monitors and other electronic charts including Sunrise and Epic in order to display a selection of them to the ICU staff. Changes deemed critical, or life-threatening, are marked in special ways to capture the attention of eICU staff. This alert should trigger an intervention that, in theory, translates into an improvement in clinical condition. Even from this brief description, it becomes evident that there is the potential limit to when and where the informational load of eICU staff is exceeded. It is also unclear what the optimal ratio of staff to patients is and at what time it would need to change. Is the current staffing model adequate or new paradigm is needed? Having, for example, a cloud of doctors interacting with the patient may be the much more flexible solution.