- The Washington Times - Monday, January 3, 2005

BUFFALO, N.Y. (AP) — Lucille Lamarca could feel her heart begin to beat at a worrisome pace as she lay alone in the intensive-care unit at Buffalo General Hospital with a heart condition.

Then a reassuring voice sounded from a speaker.

“Hi, I’m here,” the voice said. “The nurse is on her way. You’re going to be OK.”

It was the voice of a doctor who had been keeping an eye on Miss Lamarca from an office building miles away, via a camera and a bank of computer screens.

The hospital’s parent, Kaleida Health System, is among an expanding number of hospital systems adopting “enhanced intensive-care” technology — known as eICU — that allows critical-care doctors and nurses to monitor dozens of patients at different hospitals simultaneously, much as an air traffic controller keeps track of several planes.

From the Kaleida control station yesterday, health professionals were monitoring 58 patients at two hospitals via screens that displayed patients’ diagnoses and progress, doctors’ notes and vital signs, such as heart rate and blood pressure.

The professionals watching from afar alerted those on duty at the hospitals to changes or problems through videoconferencing equipment at the nurses’ stations.

Kaleida, which expects to bring its three other hospitals online in the spring, stressed that the technology is meant to enhance, not replace, in-person care by allowing doctors to catch and respond to trouble more quickly.

Kaleida is investing $4 million in personnel and equipment.

The technology by Baltimore-based VISICU Inc. is in use at at least 18 hospital systems nationwide, said Kaleida, which this summer became the ninth system to go online.

“I think that it changes the quality of the care in a way that could not be equaled, even if you doubled or tripled the staffing on site,” said Dr. Cynthia Ambres, Kaleida’s chief medical officer.

Those familiar with the technology predicted it would become part of the future of critical care nationwide, enabling hospitals to make the best use of a limited number of intensive-care doctors.

Leapfrog Group, a nonprofit coalition of business and other groups working to improve hospital operations, says there is a severe shortage of intensive-care specialists in the United States — fewer than 6,000 at a time when nearly 5 million patients are admitted to ICUs each year.

Sentara Healthcare was the first system to install eICU — 4 years ago — and monitors 95 beds at five of its hospitals in Virginia and North Carolina. Sentara officials say the technology allowed them to save 97 lives in 2003, while covering 65 beds.

Typically, hospitals rely on nurses to notice a problem with a patient. The nurse then has to page a physician. And the doctor rushes to the ICU to check on the patient.

With the new technology, “all that information is brought to me,” said Dr. Steven Fuhrman, Sentara’s eICU medical director.

He can check the patient’s ventilator, intravenous medication and anything else in the room — “The camera is such that I can count eyelashes” — while talking to the patient and staff members in the hospital.

“It’s been described here as being in the room with your hands in your pocket,” Dr. Fuhrman said.

Dr. Ambres said the in-room cameras, which are not always on, are seen as reassuring by patients, rather than an invasion of privacy.

Miss Lamarca, who was hospitalized in August, agreed.

“When you’re in the ICU, you’re very defenseless, and they were sensitive to that,” she said. “I never felt it was an invasion of privacy.”

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