UMMC's Tele-ICU addresses critical care doctor shortage; keeps patients in community hospitals

Technology allows us to connect to just about anyone in the world with a touch of a button. Much of the same technology is also helping to save lives in intensive care units across the country, through the field of telemedicine. 
The University of Maryland's eCare Tele-ICU is allowing ICU patients in rural areas to have round-the-clock access to critical care doctors, when they're not even in the same building or even the same county. 
"It's starting to really catch on," said Dr. Marc Zubrow, eCare medical director. " Right now about somewhere between 12 and 13 percent of all ICU beds in the United States are under some form of Tele-ICU system, so it really is coming into mainstream medicine." 
The technology is in in nine hospitals across Maryland. All the bedside nurse or physician has to do is press an "e-lert" button and immediately get access to the critical nurse or physician on duty.
"Within usually 30 seconds, we get a computer generated alert and we can camera right into the room and see what is going on," Zubrow said.
The eCare doctors use sophisticated computer systems to get real-time updates on a patient's vital signs, tests and conditions. They remotely monitor patients overnight, on weekends and holidays, when the hospital's ICU doctors are not working. Patients aren't alone. There are nurses on location 24-7.
"We are totally interfaced with the local information system at the local hospitals," Zubrow said. "When a lab result becomes available in Berlin, Md., we get an instant computer notification, so we are instantaneously aware when something is abnormal." 
The hospital rooms are outfitted with cameras and microphones, so that doctors and nurses at the University of Maryland eCare hub can interact with patients and hospital staff. ABC2 tested the system by doing a remote interview with Anne Lockhart, nursing director of critical care at Calvert Memorial Hospital, 60 miles south of Baltimore in Prince Frederick. Five years ago, the hospital was the first in Maryland to adopt eCare.
"It has been a wonderful experience," she said. "We see that our length of stays of our patients in our intensive care unit has decreased over time. Our mortality statistics, et cetera, have improved."
Tele-ICUs help to address the nationwide shortage of critical care physicians, also called intensivists, who specialize in the treatment of patients in intensive care. It also keeps patients in their communities, instead of transferring them to ICUs at larger hospitals. 
"They're just not enough intensivists or critical care physicians in the United States period," he said. "And the smaller communities don't have the financial resources to maintain intensivists on a 24-hour basis." 
Lockhart said the system is in place not to cut down on staffing, but to provide an extra layer of safety when people's lives are on the line.
"This is about providing a higher level of care, an extra set of eyes, and really treating these patients in the community, under certain circumstances, and keeping them at home," she said.
Every ICU bed on the Eastern Shore is now plugged into the eCare system. Two more hospitals will come online within the next three months and eCare staff are also working on their first international partnership with St. Luke's Hospital in Haiti. That partnership should be up and running within the next three months. 
The nine hospitals partnering with eCare are:
  • Calvert Memorial Hospital - Prince Frederick
  • Peninsula Regional Medical Center - Salisbury
  • St. Mary's Hospital - Leonardtown
  • Atlantic General Hospital - Berlin
  • Union Hospital of Cecil County - Elkton
  • Meritus Medical Center - Hagerstown
  • University of Maryland Shore Medical Center at Chestertown
  • University of Maryland Shore Medical Center at Dorchester
  • University of Maryland Shore Medical Center at Easton


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