Warming Up to Telemedicine

Inside the e-ICU “[The system] can do things that a human being can’t,” says New York-Presbyterian e-ICU director Dr. Hal Wasserman. [1] Stores and displays patient care history—X-rays, lab test results, meds. [2] Prioritizes patients by severity; allows staff to write medical notes. [3] Audibly signals alarming changes in vital signs. [4] Displays live video of patient (not shown). [5-6] Telemetrically monitors vitals like EKG waves and heart rate in real time. [7] Digital video cameras monitor ICU beds. Jordan Hollender

"I know these patients better than anyone on the floor right now," asserts critical-care specialist Dr. Joseph T. Cooke, who's checking up on 38 ICU patients at New York-Presbyterian hospital—from across the street. Welcome to the electronic ICU, where bedside manner means ringing a doorbell before observing patients via video camera, then checking vital signs on four remotely located monitors. Surreal? Sure. But it's telemedicine that seems to be, gingerly, living up to the hype. The system's developers, Visicu, have installed e-ICUs in eight hospitals nationwide, with eight more in the works. Most agree that traditional ICUs are costly and hard to manage: ICU admissions account for only 10 percent of inpatient beds and 30 percent of hospital costs. And up to 20 percent of ICU patients never check out. The e-ICU, where one doctor and nurse can keep 24-hour watch on as many as 50 patients at once, is boosting chronically short-staffed on-site care. A recent study reported a 27 percent drop in ICU mortality and 17 percent shorter stays since the first e-ICU set up shop at Virginia's Sentara Healthcare a few years ago. That's a cold stethoscope we can handle.