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The unexpected onset, and rapid spread, of Covid-19, has affected industries across the board. With little choice, industries were quick to transition by harnessing digital solutions. As a result, there have seen some incredible innovation and flexibility. Moreover, the situation opened doors for existing technology that provided solutions for specific problems. A perfect example is the Electronic Intensive Care Unit (eICU) – remote monitoring systems for hospital ICUs.

eICU, Covid-19 and Digitization

Organizations had to wake up, buckle up, adapt and deep-dive into integrating digital solutions into their traditional systems or operations to survive. Accompanied by the profuse problems and impact caused by Covid, remarkable innovations have changed industries for the long term. For instance, the readiness to adopt a more open-minded approach to those innovations.

With eICUs, this is particularly relevant. Pre-Covid research identified global barriers to telemedicine adoption. One expansive article published in PubMed in 2016, titled “Evaluating barriers to adopting telemedicine worldwide: A systematic review,” compiled the most shared results of 30 published works on the topic.

Before expanding on these results, the review uses the WHO definition of telehealth or telemedicine as follows:

“The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.”

The findings identified 33 barriers with a frequency of 100 occurrences through all articles. The most prolific issues were:

  • Technically challenged staff (11%)
  • Resistance to change (8%)
  • Cost (8%)
  • Reimbursement (5%)
  • Age of patient (5%)
  • Level of education of patient (5%)
  • All other barriers occurred at or less than 4% of the time

Of these findings, barriers identified in the US specifically were:

  • Cost, reimbursement, technology-challenged staff, implementation models, confidentiality
  • Privacy, legal, and technically challenged staff
  • Age, socioeconomic status, gender, level of education
  • Info overload, poor design, liability issues, cost, uncertain outcomes
  • Resistance to change
  • Hospital size, profit status, teaching status, rural setting
  • Unawareness
  • Impersonal technology (provider perceptions)
  • Bandwidth, security, state licensing, return on investment (ROI) for providers.

The Covid Turning Point

Research into eICU remote monitoring systems shows an abrupt about-turn regarding many barriers mentioned above. The driver? Covid. While telehealth services started quite slowly along with the spread of the coronavirus, it soon picked up stride, eventually reaching a full-on sprint within months.

Even the title of a thoroughly researched article published in July/August 2020 by the AAMI (Assoc. for the Advancement of Medical Instrumentation) shows this industry transition – “A Turning Point for Telehealth: COVID-19 Spurs Rapid Uptake of Connected Care.” The article includes some eye-opening statistics that of note reflected the early days of the virus at three of the most prominent US hospitals:

  1. Stanford Healthcare: By March 30, providers were logging telehealth consults at a rate of around 3,000 a day, a 50-fold rise compared to previous months.
  2. Cleveland Clinic: Before the epidemic, telehealth was already well established, averaging about 3,400 telehealth visits a month. In March, this figure jumped to 60,000, accounting for a total of 80% of patient visits.
  3. NYU Langone Health, NYC: In six weeks (ending mid-April), the daily average number of nonurgent and urgent care visits via telehealth increased 4,345% and 683%, respectively. During those 44 days, NYU saw 144,940 telehealth visits with 115,789 unique patients delivered by 2,656 providers.

Many recent articles are now shining a light on the benefits of eICU and hailing it as a life-saving tool. But, what does this tool comprise? Let’s take a look.

The eICU Digital Module

We have so far reviewed the barriers eICU faced and its emergence from the shadows during COVID alongside most industries having no option but to adopt revolutionary digital transformations. But what are the digital components of an Electronic Intensive Care Unit (eICU)?

An eICU support center uses state-of-the-art technology coupled with eICU caregivers, including ICU interventionists and nurses, to provide 24/7 critical care services for patients at numerous hospitals concurrently and irrespective of their geographic location.

The unit achieves this by using various technologies, such as:

  1. Scalable, centralized, and decentralized platforms integrated with medical devices for easy viewing and capturing medical data and vitals.
  2. Clinical ICU patient data capture directly streamed to the tele-ICU
  3. Real-time monitoring technology based on information conveyed by phone or entered into a computer from the bedside
  4. Monitoring of various clinical indicators including heart rate, blood pressure, oxygen saturation, ventilator settings
  5. ICU beds equipped with two-way surveillance cameras with PTZ and recording functionality
  6. Multiple video monitors
  7. Wheeled robots integrated with tablets and cameras, controlled through a webcam and a joystick, and fitted out with enhanced obstacle and navigation detection abilities. This futuristic, interactive system allows physicians to interact with patients face-to-face while viewing other monitoring devices. This tool has been particularly beneficial during Covid, where patients suffer isolation and staff are less infected.
  8. Microphones
  9. Facility for video conferencing and for offsite clinicians to chat with bedside teams 24×7
  10. Smart alarm software connected by high-speed data lines to alert on-site clinicians to significant changes in patient status
  11. High-speed-dial call center communication services and remote consultation
  12. Electronically capacity to receive laboratory results, X-rays, and patient care plans
  13. Systems can manage multiple geographically dispersed ICU locations reducing patient transfer

Besides the above, new technologies must be in-line with standards in the medical industry, such as:

  • Meeting Health Level Seven (HL7) international standards for transferring clinical and administrative information between software applications used by different healthcare providers.
  • HIPAA Compliance: The standard for the privacy and security of Protected Health Information (PHI) set by The Health Insurance Portability and Accountability Act.

Takeaway – eICU is a worthy investment

While Covid has had far-reaching and devastating effects worldwide, it has led to digital revolutions in specific industries opening doors to invention, acceptance, and adoption. eICU uptake has benefited by overcoming barriers of technological maturity. eICU has achieved this by persuading leadership that eICU is a worthy investment, convincing healthcare providers that telemedicine is an efficient way to treat patients, and making staff accept the idea and learn new strategies. Significantly the process has involved educating patients about the technological skills required to access eICU.

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