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Tuesday, January 04, 2005 - Page updated at 03:41 P.M.

Cameras helping doctors watch patients from afar

The Associated Press

Enlarge this photoSHARON CANTILLON / ASSOCIATED PRESS

Colleen Dowd, director of Kaleida Health System's eICU, demonstrates how the camera and computer system works in Buffalo.

BUFFALO, N.Y. — Lucille Lamarca could feel her heart begin to beat at a worrisome pace as she lay there alone in the intensive care unit at Buffalo General Hospital with a heart problem.

Then from a speaker came a reassuring voice.

"Hi, I'm here," the voice said. "The nurse is on her way. You're going to be OK."

It was the voice of a doctor who had been keeping an eye on Lamarca from an office building miles away, via a camera and a bank of computer screens.

The hospital's parent, Kaleida Health System, is among an expanding number of hospital systems adopting "enhanced intensive care" technology — known as eICU — that allows critical-care doctors and nurses to monitor dozens of patients at different hospitals simultaneously, much as an air traffic controller keeps track of several planes.

From the Kaleida control station yesterday, health professionals were monitoring 58 patients at two hospitals via screens that displayed patients' diagnosis and progress, doctors' notes and vital signs, such as heart rate and blood pressure.

The professionals watching from afar alerted those on duty at the hospitals to changes or problems through videoconferencing equipment at the nurses' stations.

Kaleida, which expects to bring its three other hospitals online in the spring, stressed that the technology is meant to enhance, not replace, in-person care by allowing doctors to quickly catch and respond to trouble more quickly.

Kaleida is investing $4 million in personnel and equipment.

The technology by Baltimore-based VISICU is in use at at least 18 hospital systems nationwide, according to Kaleida, which this summer became the ninth system to go online.

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"I think that it changes the quality of the care in a way that could not be equaled, even if you doubled or tripled the staffing onsite," said Dr. Cynthia Ambres, Kaleida's chief medical officer.

Those familiar with the technology predicted it would become part of the future of critical care across the country, enabling hospitals to make the best use of a limited number of intensive-care doctors.

Leapfrog Group, a nonprofit coalition of business and other groups working to improve hospital operations, says there is a severe shortage of intensive-care specialists in the United States — fewer than 6,000 at a time when nearly 5 million patients are admitted to ICUs each year.

Sentara Healthcare was the first system to install eICU 4-1/2 years ago and now monitors 95 beds at five of its hospitals in Virginia and North Carolina.

Sentara officials say the technology allowed them to save 97 lives in 2003, while covering 65 beds.

In Washington state, Swedish Medical Center is the only hospital that has adopted the technology, according to VISICU spokeswoman Jennifer Diven. Ed Boyle, Swedish spokesman, said it is used to monitor 42 ICU beds at Swedish's First Hill campus.

"It's not intended to replace bedside care," Boyle said. "It's intended to be a second set of eyes and ears, providing an additional safety net."

Typically, hospitals rely on nurses to notice a problem with a patient. Then the nurse has to page a physician, and the doctors run to the ICU to check on the patient.

With the new technology, "all that information is brought to me," said Dr. Steven Fuhrman, Sentara's eICU medical director.

He can check the patient's ventilator, intravenous medication and anything else in the room — "The camera is such that I can count eyelashes" — while talking to the patient and staff members in the hospital.

"It's been described here as being in the room with your hands in your pocket," Fuhrman said.

Ambres said the in-room cameras, which are not always on, are seen as reassuring by patients, rather than an invasion of privacy.

Lamarca, who was hospitalized in August, agreed.

"When you're in the ICU, you're very defenseless and they were sensitive to that," she said. "I never felt it was an invasion of privacy."

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