Care in the ICU has always been intense
The level of complexity in providing care to patients in an intensive care unit is extremely high. As monitors are beeping, ventilators are mechanically supporting patients’ breathing and infusion pumps are administering medications drop by drop, the work each piece of equipment does is essential. However, the question that still needs to be answered is whether all the equipment is operating as one cohesive system.
A Room Full of Devices—or a System?
When you walk into an Intensive Care Unit (ICU), you will find the most current medical technologies at work every day. The patient is attached to a machine that monitors the vitals (heart rate, respiratory rate, etc.) and another device that assists with breathing (ventilator). Finally, the patient has several intravenous pumps providing medications directly into the bloodstream. Each device is a powerful tool by itself, but they have always been separate from each other. The human clinician has provided the link between the devices. The clinician is constantly watching and interpreting the information from the monitors, as well as intervening when there is an issue. While this human connection is important, it limits the clinician as they have to review all of this information within a very short time frame, so time is critical in a critical care unit.
What Happens When Devices Start Talking?
Let's consider another situation, in which the patient's oxygen saturation level is dropping. The monitor immediately recognizes this and not only generates an alarm but also sends the information to the entire system. The ventilator changes the amount of assistance it provides, all of the associated alerts are sorted according to priority, and all medications that could be given to help the patient are evaluated in real time. There are no delays and the responses are not broken into different segments. This is an example of what a connected ICU provides.
Interoperability: The Missing Link
To transform the way we deliver care, we must first address some important aspects of how we perform this transformation, specifically about the interoperability of our devices, so that they can all communicate, share, and understand each other's data. In an ICU that is fully connected, data will flow freely and continuously between devices; alerts will be integrated; and information will be consolidated, rather than fragmented. The clinician will have the opportunity to view a more complete and consolidated view of the patient, as opposed to viewing multiple screens with different sets of numerical/data.
Why This Matters More Than Ever
Delays in critical care can quickly escalate into major issues. Missed trends, slow responses, and excessive alarm activity can all directly impact patient outcomes. When devices work together as a coordinated system it allows for faster detection and more accurate responses while making life easier for clinicians. The objective is to assist, but not replace, clinicians when they are needed the most.
Behind the Scenes: A System of Signals
The use of ICU devices means everything is a measurement instrument; for instance; when monitors measure things such as blood oxygen levels, blood pressure readings, electrical impulses, and blood volume; they collect data representing the patient's condition, which may then be processed and presented as valuable information if the various types of devices all operate successfully together (provided the data is filtered out so only relevant data is used, synchronized across various devices, and properly introduced into the overall understanding of the patient). Thus, the connected ICU consists of many devices sharing real-time signal information to create a complete patient view through discourse among all devices regarding the relevant patient.
The Challenges We Can’t Ignore
The challenges involved in transitioning to a connected ICU are many. One of the key challenges is that manufacturers have adopted various methods of communicating with different systems, creating complexity with how the connections can be achieved. If not managed carefully, the amount of data generated by these systems can become an obstacle, rather than a help. Once connected, systems must be designed for reliability and data security. Building a connected ICU requires innovation, design, standardization, and trust in the system.
From Reaction to Prediction
The future of the Intensive Care Unit (ICU) is to find ways to be proactive rather than reactive. As devices will talk/communicate with each other, more data will be collected, and as more data is collected, a number of patterns will emerge, which will lead to early warning systems as well as predictive monitoring, with the implementation of AI-assisted decision making. Therefore, the ICU will begin transitioning from a reactive state to a proactive state with respect to anticipating future crises.
Final Thought
Progress in healthcare is usually measured using individual device advancement; however, the true change is now happening through interconnecting multiple devices and their individual functions towards optimally providing the best patient care. Improvement of care in the ICU is not achieved by having superior machinery; rather it requires connected intelligence, collective data signals, and a capacity to intervene at the precise time and place for a specific patient.
