Around six million Americans are admitted to the ICU (Intensive Care Unit) every year, contributing to 30% of total hospital costs. ICUs that are staffed by intensivists (physicians that specialize in treating critically ill patients in the ICU) have been shown to have better outcomes and lower mortality.

However, hospitals across the nation are struggling with severe intensivist shortages (as well as critical care nurse shortages). One expensive solution to address these shortages while dealing with the complexity of ICU care involves telemonitoring of patients (also called eICU) from a central station that is located in a far-away location.

The idea is very similar to how air traffic controllers and onboard technology for pilots work. An eICU is staffed with intensivists, critical care nurses and administrative personnel that can monitor and care for hundreds of patients at a time, similar to how air traffic controllers monitor hundreds of planes at a time. Also, in an airplane, the pilots use on-board sensors to identify problems and intervene to prevent accidents. Similarly, the eICU care team uses a combination of visual and electronic monitoring and software tools to track patients and avoid complications.

For example, in the case of alteration in patient blood pressure readings (an early indicator of possible complications), the eICU staff receives an alert from the software. The staff can then use remote-control communication devices to see and hear ICU activities and orally communicate care orders to the bed-side ICU staff. Through constant surveillance, and by providing the physicians with timely needed patient information, eICUs have been associated with a 55% reduction in ICU mortality and a 40% reduction in clinical complications.

The eICU is not a new idea: the first program was tested in 1997. Yet, only 9% of ICU beds in the US are monitored using eICU today. One might speculate that the need for eICU exists mainly in small rural communities. However, recent research has shown that the majority of hospitals using the technology are in large urban markets, and that the main reason for its use is as a backup system that provides a second set of eyes for the bed-side care team.

The eICU has a huge potential to improve patient care and address acute staff shortages in isolated areas. The main obstacle remains the huge up- front cost of this technology and the significant on-going operating costs.