Computerworld - When Leo Dufault had what should have been a fatal heart attack almost three years ago, it was an alert bystander who knew CPR that kept him alive. But once he was at a community hospital, it was a critical care physician -- who was 25 miles away -- who saved his life through a remote IT system.
The electronic intensive care unit, or eICU, where Dr. James Shaffer was located allowed him to remotely instruct and watch emergency room physicians as they put Dufault into a coma using therapeutic hypothermia to lower his brain's temperature to 91.4 degrees Fahrenheit to reduce damage from loss of oxygen.
"This isn't a guy who fell down and bumped his head. He was dead," Shaffer said. "We were able to teach the bedside staff how to do the procedure. It went off without a hitch. The beauty of it is that Leo did well."
After inducing the coma, Shaffer was able to then monitor his patient for 10 days through the eICU, which allowed him to watch Dufault through a high-definition, two-way robotic camera that could zoom in close enough to detect changes in the capillaries in Dufault's pupils. Special software monitored Dufault's vital signs, and preset alerts based on Dufault's medical history alerted Shaffer to even the smallest changes in white blood cell count, oxygen levels and heart arrhythmia.
As healthcare and technology converge, more and more doctors will be able to do what Shaffer did: remotely intervene to save patients' lives and monitor their conditions from a distance. It's an advance in telehealth technology that also helps patient families.
For Dufault's wife, Barbara, having a critical care team monitor her husband 24 hours a day gave her peace of mind. "I was able to leave and come home, and maybe not rest, but I knew someone was watching him all the time," she said in an interview. "It was like having a private nurse right there. I just couldn't believe they could do this."
Even as Shaffer and two critical care nurses were remotely monitoring Dufault, they were also in charge of 60 to 80 other patients in five ICU units across three hospitals in the Health First healthcare system, which is based in Rockledge, Fla.
"The robotic cameras allow us to see and hear and talk to patients. Really, there are no walls," Shaffer said.
The system also has five mobile eICU carts, like the one used in the emergency room that initially treated Dufault. In April, the hospital system will add a fourth hospital to its eICU system and one mobile device, for a total of 102 remotely monitored ICU beds and six mobile carts.
In a typical ICU, during night shifts physicians respond only to emergencies when paged by charge nurses. The nurses can do very little, for example, if a patient experiences an irregular heart rhythm that could harm his health.
"[The nurse] can't even put in a urinary catheter without an order," Shaffer said. "So rather than paging a physician, which can take up to 30 minutes, they push a button or pick up a phone, and if I've not already seen the irregular rhythm, I'm clued in within 15 seconds."
It's 2020. The at-home telemedicine robot reminds me it's time for the doctor to check how well the burn on my arm is healing. The specialist is in a clinic located more than 45 miles away, but she thoroughly examines my arm through a wound assessment device built into the robot. After the consultation, my smart band reminds me that the mobile health vehicle will be at my workplace, and I should stop by to get my flu shot. I quickly acknowledge my medication reminder alert, take my meds, and then hop into my driverless smart car.
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