Online Critical-Care Supplier CEO Explains How It Works - InformationWeek

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Online Critical-Care Supplier CEO Explains How It Works

Online Critical-Care Supplier CEO Explains How It Works

Other potential uses of remote, electronic ICU technology:
The potential uses of electronic-ICU technology can be stretched beyond the actual intensive care unit, says Frank Sample, CEO of Visicu Inc., the provider of eICU technology used at Sentara and Sutter hospitals.

Most hospitals also have "step-down" units for patients who are not sick enough to remain in ICU, but not well enough to go into a regular unit. Those step-down units are also candidates for electronic-ICU care, because those patients can still be monitored closely without taking up beds in the actual ICU.

In fact, Sample says a couple of Visicu customers have already begun doing just that. New York-Presbyterian's Columbia Presbyterian Medical Center has connected a combination of 48 ICU and step-down beds to an eICU facility.

In addition, Sample says some hospitals have shown interest in wiring a few of their emergency room beds to an electronic ICU, so critically sick patients can be monitored until a bed in the ICU becomes available.

How the eICU software works, what technology is involved, and how it's priced:
Visicu's eICU software is programmed with algorithms that take into consideration "evidence-based medicine," or information about medical conditions and expected/unexpected occurrences that together or alone could be signs of an impending medical problem for patients who are critically ill.

The software analyzes the real-time vital-sign activity of a patient and sends out an audible and visible smart alert to warn the doctor or nurse monitoring the electronic ICU that a potentially troubling trend, such as a drop in blood pressure or an increased heart rate, may be developing. The vital-sign information comes from medical monitoring devices hooked up to the patient.

The software also takes into account information from the patient's electronic medical records, such as lab results or a physician's orders for meds, Sample says.

In addition, Visicu also provides software that includes so-called "Cliff Notes for critical care" that can help an eICU doctor decide on the right treatment, medicines, or diagnosis, based on information that doctor enters regarding the medical situation being seen from the eICU, Sample says.

Visicu updates its software monthly to reflect new medical findings or changes in prescribed treatment.

Except for the Visicu software, just about everything that Visicu uses to configure the eICU is off the shelf, including servers, video-conferencing equipment, and even the medical equipment/vital-sign-monitoring devices, Sample says.

"Except for our software, we utilize off the shelf for everything else. We let Microsoft, Dell, Sony, IBM do all the work" developing and providing the hardware, operating-systems software, and medical gear used in the eICU set up. "All my R&D goes into intelligence" of the software, he says.

Most hospitals' existing ICU medical monitoring devices--"unless they're very old"--have "gateways" that allow information such as vital signs to be fed to the Visicu systems electronically, so in most cases there's no need for a hospital to purchase new devices for an eICU, Sample says.

As for communications/wiring, T1 or ATM is be used to connect the traditional ICU to the remote elCU. Visicu can configure the appropriate system for specific hospitals' needs, Sample says.

For instance, while one hospital might wire one building that has 20 ICU beds on one floor, another medical center might need to wire eight buildings with dozens of ICU beds on multiple floors.

Pricing reflects that, too. It's about $1.5 million to $2.2 million for Visicu to create an eICU, and it takes four to six months to build, depending upon where the eICU is located, he says.

Possible locations for setting up an electronic ICU:
Sample does not recommend that hospitals operate their eICUs from inside the actual hospital. "That hospital space is probably better utilized for patient care, plus it removes the temptation for the doctor monitoring the eICU to run down the hallway to treat a patient in the actual ICU, leaving the other 50 eICU patients without a doctor monitoring them," he says.

Some of the hospitals that have deployed eICUs have chosen interesting locations to house the electronic monitoring center. Sutter Health in Sacramento is using floor space at a former dot-com building. But perhaps the most unusual so far is the location of New York-Presbyterian's Weill Cornell Medical Center eICU: it's situated on the mezzanine level of a Helmsley Hotel in New York, Sample says. "Hospitals will set these up wherever they can find the space," he says.

In addition to Sutter, Sentara and New York-Presbyterian hospitals deploying eICUs, others include eight hospitals of Advocate Health Care in Chicago; St. Luke Health Systems in Kansas City, Mo; and two U.S. military hospitals--Walter Reed Medical Center in Baltimore and Tripler Army Medical Center in Hawaii, which is remotely monitoring ICU patients at the U.S. Navel Hospital in Guam.

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