WCH Introduces eICU Advanced Care

January 27, 2011-Corydon: The Wayne County Hospital (WCH) eICU established a new way of using advanced telemedicine technology to benefit physicians and ICU patients across our region. Linked with the Mercy Health Network eICU Center in Des Moines the eICU provides remote monitoring capability for critically ill patients at Wayne County Hospital. Installation of this high level monitoring system was made possible with partial grant funding received through the Wayne County Foundation and a USDA Rural Development grant.

After months of intricate coordination, planning and equipment upgrades, the eICU opened in November 2010. WCH is the first critical access hospital in Iowa to provide this service partnered with Mercy Health Network. WCH has two dedicated eICU rooms for patients that require a higher level of care than the normal acute admission.  “Our eICU patients range from cardiac, stroke, or trauma victims and include many types of critical care that you might see in a larger facility. The nursing staff loves the eICU and the support it provides them in caring for their most critically ill patients,” commented Sheila Mattly, CNO. With the eICU system WCH patients benefit from the collaboration of experts.  WCH primary care physicians and nurses are able to discuss the plan of care with the Mercy eICU team and together develop the best strategy to care for the patient. The eICU has enabled WCH to provide a higher level of quality care in our rural setting.

With eICU care, physicians specializing in intensive care medicine (intensivists) from Mercy-Des Moines lead a care team that works with WCH ICU staff to monitor critical care patients around the clock. The eICU uses high resolution cameras, phones and software that evaluate real time patient physiological data for thresholds and trends. It’s a little like an air traffic control center staffed with critical care experts who are networked to multiple ICU patients across the system by voice, video and data. This data is continually monitored by an Intensivist and critical care nurses located at the Mercy eICU center.

The eICU staff looks for subtle changes in the patient’s condition and the staff then notifies the attending physician or critical care team immediately.  Because the system continuously checks and alerts theeICU staff, the WCH physician’s plan of care can evolve to prevent complications.  In addition, the off-site Intensivist can intervene in emergencies when the patient’s attending physician is not present in the ICU.  The eICU critical care team uses a real time camera which has no recording capabilities and does not watch staff or patients.  The camera is only turned on when the eICU physicians, nurses and support staff need to see the patient or when requested by the bedside staff. When the camera is on it turns toward the patient and a chime signals the camera is on. When the camera is off it turns to face the wall. A privacy indicator can be turned on by the bedside nurse when the patient and or family requests privacy. The remote team will not turn on the camera when the privacy indicator is activated unless there is an emergency.

All eICU monitoring equipment is located in a secure area at Mercy-Des Moines and is accessible only to authorized staff. Information is sent over secured lines and not transferred via the internet. Scrambling and secure passwords are used for further safeguards. With eICU care bedside care remains the same and face to face contact with patients and providers is not reduced, it simply provides an extra layer of specialized care. Local attending physicians are in charge of patient care and choose the level of interaction with the eICU Center they wish. Some physicians request contact with every order change and others only want a call if the situation becomes life-threatening.

Some of the advantages the eICU offers include: 1) The benefit of having an Intensivist and a critical care nursing team providing additional critical care support and high level intensive care monitoring; 2) Provides support to the local medical staff with 24 hour monitoring capability; 3) eICU provides early intervention opportunities: 4) Provides a higher level care for WCH patients normally available only in larger hospital systems; 5) Results in a decrease in transfers so patients and families are able to remain close to home; and 6) Provides faster recoveries and a decrease in mortality rates.

In addition, the eICU has improved attending physicians’ quality of work life with the eICU taking calls at night and having the ability to contact the local attending physician as needed. This is helpful and noteworthy when recruiting new physicians.

“Care of critical patients in eICU communities is a partnership,” said Dr. Michael Witte, Medical Director for Mercy eICU Connect. “Local physicians are dedicated to their patients, who are also their friends and neighbors.  We work directly with those physicians to deliver the best treatment possible.”

Numerous studies show when an attending physician teams with an Intensivist, ICU patients experience faster recoveries, leading to improvements in patient outcomes. However there is a severe shortage of Intensivists especially in rural areas.

“The value of this system is in providing an enhanced level of care where our physicians and nurses can discuss the plan of care with the Mercy eICU team and in that planning determine the best strategies for those critically ill patients. This technology is at no cost to the patient. We are not charging an additional fee for this. We believe we can provide high quality care in the rural setting that we’re in and eICU helps us achieve that level of care,” commented, Daren Relph, CEO. Patients, families, and providers are excited about the outstanding results. For more information on our eICU or any other service at WCH, please contact Laurie Ehrich, CCO at 641-872-2260 ext: 5327.