All is quiet in the room where walls of screens stacked at six workstations monitor 26 vital signs of 96 intensive-care patients in a kind of mission control for the critically ill located in various hospitals.
At the Baptist Health System, this electronic intensive-care unit could be the model for future remote monitoring, with software helping specially trained medics keep a constant finger on the pulse of the sickest patients.
Silent alarms are triggered at the eICU, housed in an office building next to Northeast Baptist Hospital, when a troublesome trend in vital signs emerges in an ICU bed at one of five Baptist hospitals in San Antonio. Cameras can zoom in on instrument panels inside the room and staff can interact with the patient by screen or voice and notify on-site personnel quickly if something is amiss.
The computer prompts workers’ next moves from conversations with patients to summoning physicians, eICU registered nurse Richard Jaroszewski said.
While Baptist’s eICU has been around for 10 years, bulky computer monitors have given way to 40 large flat-screens and improved monitoring capabilities, both predictive and preventive.
With hospital staff at times stretched to the limit during the summer, the darkest point of the COVID-19 crisis in Bexar County, the reliance on remote technology and all its promise makes the eICU look more like the future of health care.
Texas only sports a handful of eICUs, and a small percentage of hospital systems nationwide have taken the leap to centralized monitoring, said Jill Scott, a Baptist RN who is the program’s supervisor.
The computer network shows staffers a list of the 20 most-ill patients across all of the ICUs so they already know where to focus attention between the personal visits of ICU personnel.
If something goes wrong, RNs in the eICU core can give advice and protocols to health care workers in the room. Most eICU registered nurses possess at least a decade of intensive-care experience or advanced training, and encountered more situations than most of in-hospital staff, Scott said.
In overnight hours, three RNs, a patient-support specialist and a physician known for dealing with critical patients – an intensivist – man the core.
San Antonio, home of many military medical missions, is pioneering similar programs for armed-services hospitals from a nerve center at Brooke Army Medical Center.
“The Military Health System is investing in the expansion of tele-critical care and Brooke Army Medical Center is at the center of the expansion with the installation of monitoring systems for 66 beds,” said Army Col. Sean Hipp, director of the Virtual Medical Center.
“BAMC will have the most monitored beds in a military hospital, but is also using the subject matter expertise of critical-care nurses and physicians to support other military hospitals without the same critical-care capabilities,” he said. “The goal is to give high quality and consistent critical-care oversight throughout the Military Health System.”
Scott said she foresees the technology and the concept of monitoring from a core location extending into non-ICU patient rooms with the use of a mobile unit with cameras in cases where a closer eye is needed.
Plus, Scott believes mobile monitoring technology might one day be in homes.
“I can see it being used more and more for prevention,” she said.