Emory Critical Care Network Ready for Current Realities and Future Needs

October 2014

The patient was turning blue. Heart rate 40, blood pressure 50, oxygen saturation 60. Lung dysfunction kicked in with a decline in vital signs. The ICU on-call physician was 15 minutes out. Miles away, an RN at the Emory Electronic ICU (eICU) detected the deterioration. She alerted the on-service eICU physician, who watched the patient's vital signs, ordered medications, reviewed lab data, and guided the critical care medicine nurse practitioner at the patient's bedside through advanced resuscitation techniques via high definition audiovisual tools. The patient stabilized.

Located in the Doctor's Center Building at Emory Saint Joseph's Hospital (ESJH), the eICU is linked to ICUs at ESJH, Emory University Hospital (EUH), EUH Midtown, and East Georgia Regional Medical Center by HIPAA-secure, bi-directional AV technology and digital connections that carry encrypted medical data. Emory Johns Creek Hospital will join soon.

Funded by a Health Care Innovations Award (HCIA) from the Centers for Medicare and Medicaid Services, the eICU was initiated by Dr. Timothy Buchman, Emory Critical Care Center (ECCC) director, to expand access to critical care services, lower costs, and address the looming national shortage of critical care physicians.

Telemedicine provider Philips Healthcare installed cameras, monitors, microphones, and speakers in the participant ICUs as well as vital sign, patient monitoring, flowsheet, and lab interfaces and servers for data streams and storage. All hardware/software derived patient data from the ICUs routes to the eICU and its 24-7 monitoring personnel, who work closely with providers in the member ICUs as they treat patients.

"Now our ICU nurses have a second pair of eyes watching their patients," says critical care nurse Cheryl Hiddleson, operations director of the eICU. "When other physicians have gone home for the day, we have an ICU physician available at the push of a button."

The HCIA grant also provides support for two residencies in the ECCC. A one-year critical care residency is recruiting, training, and deploying NPs and PAs throughout the Emory system. A six-month HCIA residency provides critical care training for providers in other fields from hospitals in Georgia's underserved communities. When certified, the PAs and NPs return to their hospitals, which will improve access to community ICU healthcare across the state and eventually serve thousands of Medicare and Medicaid beneficiaries.

"The next phase will be adding the emergency departments at EUH and Midtown," Dr. Buchman says. "Patients requiring critical care will be tracked as soon as they enter the Emory system, further widening the range and scope of the data needed to make informed decisions."

The project described was supported by Grant Number 1C1CMS331041 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this website are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.

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