by Douglas Walter
Staff nurse Wayne Potter prepared to demonstrate some of the high-tech features in one of the 16 rooms in North Colorado Medical Center’s new iCare intensive care unit in Greeley, until someone beat him to the punch.
"Hi Wayne, it’s Heather," said a voice over a speaker in the room.
A motorized camera on the wall buzzed to zoom in on Potter’s position.
It was fellow nurse Heather Holcom in Mesa, Ariz. She was at sister hospital Banner Desert Medical Center, checking in while looking at computer screen with Potter’s live image.
From Mesa, Holcom can also look at all the vital signs of patients staying at North Colorado’s eICU.
"Basically, I have a lot of data at my fingertips," she explained over the speaker.
It’s all part of a new approach at North Colorado Medical Center’s new eICU and iCare, where bed-side doctors and nurses are joined with nurses and doctors hundreds of miles away to help monitor and care for the patients via computers and video cameras.
Much of the iCARE technology actually comes into play at night, when doctors aren’t on the floor and only staff nurses are monitoring the patients. With iCare, a doctor at the clinical operations room nearly 1,000 miles away in Arizona is also there, helping keep an eye on the patient. More important than the camera, the doctor has all the information at his or her fingertips – current vital signs, trends, and even x-rays.
Banner Health is one of the first hospital systems in the country to implement the virtual-doctor program and the first to do it crossing state lines. Including North Colorado Medical Center, the operations room in Mesa monitors patients in five other hospital, 76 beds in all.
Banner officials also plan to expand its capacity to 250 beds in the near future. All of it will be based on the virtual doctor model.
Does is sound like big brother? Potter admitted there were some initial fears about someone with an electronic eye looking in on the bedside work of nurses. But those fears are passing.
"It doesn’t change nurse assignments – no more than two patients per nurse," he said. "It’s just not that kind of thing that can change that. You always have to have someone at the bedside. This is just an extra set of eyes."
And for newer nurses, Potter said having the doctor on hand, even if it’s a virtual doctor, increases comfort and security.
Dr. Robert Groves, who formerly worked at the ICU in Greeley and now is at the other end of the camera in Arizona, calls the use of technology an added layer of protection for the patient.
"We are not doing this to watch nurses, we are doing this to watch the patient," Groves said.
He said the camera plays a partial role in the care of the patient and is usually pointed at the ground and has not recordingcapabilities.
Groves monitors a complete medical history, checks current vital signs or vitals from anytime during the patient’s stay. The computer can alert him if something appears wrong and allows Groves to look at trends over time.
"Then if I want to, I can pan into the room with a high resolution camera," Groves said, adding that the camera is so clear that he can read labels on medication bottles setting near a patient’s bed.
He said the iCare method reduces mortality rates and shortens hospitals stays because there’s a better monitoring of patients.
"In a collaborative relationship, we get the right care right now," he said, pointing out that there is always a physician with and eye on the patient.
He explained there were also some concerns that system would replace bedside care. But he said it’s more of an attempt to fill in the holes. Nurses and doctors on the floor can’t be everywhere all the time.
It’s also a response to a shortage of ICU doctors. There’s not enough to staff floors 24 hours a day. With iCare, one can do the job of many.
"But even if there wasn’t a shortage, this is still good medicine," Groves said.
The extra layer of protection, or the extra set of eyes, essentially provides an over encompassing approach at care where subtle signs of trouble with a patient is less likely to fall through the cracks, he said.
And while the iCare system is a step toward a different kind of medical, Groves said it still takes a sharp staff on either side of the camera.
"You really have to have good relationships with the staff to make this work," he said.
Holcom agreed. "We support each other," she said, speaking from Mesa.