Tele-ICU systems links Yale ‘intensivists’ to patients in Westerly

Tele-ICU systems links Yale ‘intensivists’ to patients in Westerly

The Westerly Sun

WESTERLY — In addition to the care they receive locally, patients in the intensive care unit at Westerly Hospital are now being monitored in real time, through the use of audiovisual technology, by a team of critical care doctors and nurses 62 miles away at Yale New Haven Hospital.

The team in New Haven is working through the Yale Health network’s InSight Tele-ICU system, which allows consultation between the hours of 7 p.m. and 7 a.m.

Dr. Oliver Mayorga, Westerly Hospital’s chief medical officer, said the telemedicine initiative supplements the work of hospitalists and nurses who staff the hospital at night and provide care to both ICU patients and those admitted elsewhere in the facility.

“This is above and beyond what we had,” Mayorga said.

“This actually allows, essentially, second-by-second monitoring,” he added.

At Westerly Hospital two patient rooms are outfitted with video cameras, microphones, and speakers and monitors. The equipment is connected to the tele-ICU center, where doctors and nurses called intensivists — because they are trained in critical care — monitor patients’ vital signs through a live feed called a “vitals bridge.”

A telemedicine cart is being used in Westerly’s seven other ICU rooms. Twenty iPhones equipped with a secure texting app are distributed nightly to nurses, doctors, respiratory therapists and other health care professionals as part of the system. The team in New Haven receives a rundown on ICU patients in Westerly each night at the start of their shift.

The equipment and other computer technology gives the intensivists access to the same information that they would use at the bedside, including patients’ electronic medical record.

Telemedicine in general is meant to boost ICU capabilities at small community and rural hospitals, and is part of a growing trend. Community hospitals like the one in Westerly can benefit by tapping the expertise of doctors on the “cutting edge of medicine who tend to be attracted to academic medical centers,” Mayorga said.

If a change occurs in a patients’ vitals the tele-ICU team immediately notifies doctors and nurses in Westerly. The technology uses algorithms to analyze patient symptoms and vital signs and automatically moves patients to a higher level of monitoring when warranted.

Privacy concerns

The remote ICU team also has the ability to turn the camera on in a patients’ room and will do so immediately in emergency situations. Otherwise the cameras are turned on only with a patient or family member’s consent. None of the audio or visual communications are recorded.

The system, for patients who agree, is used to perform nightly “camera rounds.” During the rounds doctors in New Haven can see and speak with patients and their caregivers in Westerly. “It’s just an extra set of eyes,” said Meredith Johnson, the Yale system’s associate director of tele-health.

Members of the team in New Haven are all licensed to practice medicine in Rhode Island and are credentialed to work at Westerly Hospital.

Carrie Kenyon, a registered nurse and nurse manager of the Westerly Hospital ICU, said the system allows very sick patients to stay in Westerly. “In the past they might have had to be transferred out but now we can keep patients here in their community hospital where they want to be,” she said.

Yale New Haven Health, Westerly Hospital’s corporate parent, spent $290,000 to outfit Westerly Hospital with tele-ICU capabilities. The local hospital has been part of the Yale system since last September, when Yale became the corporate parent of L+M Healthcare, of New London, which acquired Westerly Hospital in 2013.

Yale pledged to invest $300 million in eastern Connecticut and western Rhode Island as a condition of the affiliation.

Enhancing care

“The goal of the affiliation was to enhance care and that’s what the tele-ICU does. This is a direct result of the affiliation,” said Michael O’Farrell, Westerly Hospital spokesman.

The tele-ICU rests on a framework provided by the Epic medical record system. The system that the Yale system has used for years was installed and activated at the L+M and Westerly hospitals in January.

“The Epic system is the backbone of this program. Epic allows us to look at a patients’ medical records in the same way as staff in Westerly,” Johnson said.

Westerly Hospital’s ICU is the fifth unit supported by the Yale InSight system, which is running in 72 patient rooms across the Yale system.


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