Critically ill patients now have access to 24/7 monitoring in the intensive care unit (ICU) at Womack Army Medical Center (WAMC). This service known as tele-critical care is a new tool that provides the best possible care, day and night to critically ill patients by utilizing experts in the medical field who can get them help immediately.
Lt. Col. (Dr.) David Hostler, chief of pulmonary and critical care medicine, explains how this tool works.
“The tele-critical nurses monitoring the patients remotely 24/7 see everything from the notes that we put in, images, labs, and telemetry, in real time. So, if one of our nurses has patients in rooms one and two and is in room two giving medicine and something happens in room one, there is a nurse looking into that right away.”
The system uses real time audio and video monitoring, so patients receive continuous monitoring with their consent. However, according to Hostler, despite the video capability it is not monitoring continuously, it is only on when needed. If there is a situation where the patient requires an extra nurse or doctor with some expertise, there is one available at the push of a button. A service, Hostler says is beneficial to patients in the ICU.
“There is two decades of research showing that having a board-certified intensivist involved in critically ill patients care improves their outcomes,” said Hostler. “Now we can do that 24/7 instead of just certain weeks or days.”
According to Col. (Dr) David De Blasio, deputy commander for medical services, this service is not new, but in the last five years it has become the health care industry standard for hospitals that don’t have a board-certified intensivist physically at their bedside all the time.
“We have great ICU nurses and the Army makes great ICU doctors, tele-critical care allows us to have that intensivist inside, in the middle of the night or be in the hospital 24/7,” said De Blasio.
It doesn’t matter who is at the bedside, patients now have a subject matter expert always over their shoulder and willing to help at a moment's notice.
The tele-critical care is on a mobile cart that can be easily transported from one room to another, however the plan is to have it available in all ICUs, the stepdown unit and two emergency rooms.
De Blasio said, “What it does is, it takes the resources that we have that is in finite supply and allows it to spread over a much larger catchment area. It enables the pulmonary critical care doctor to become a force multiplier across multiple platforms from a military standpoint, because that is where this technology originated.”
A fail-safe mechanism is how De Blasio describes it, because there is a doctor on the other side of the screen to help guide the care of a patient in the ICU in case of an emergency if the doctor in-house is taking care of another patient at that time.
“It’s always there, that to me is where a fail-safe mechanism comes in, because when everything else fails, this is here always to be safe for the patient,” said De Blasio.
Tele-critical care has brought much reassurance to patients who have given their consent to use it. A tool they never knew existed; however, they are glad that it is available.
WAMC is a unique hospital that serves service members, retirees and their family members, with thousands of paratroopers and frequent jumps, this service is a necessary tool in keeping with the readiness mission.
“What it does is it helps us to take care of our own,” said De Blasio. “The value in that should not be underestimated.”