The ICU is getting a digital makeover

The Intensive Care Unit (ICU) is undergoing rapid digital transformations because leveraging clinical data is essential for promoting ongoing improvements in the delivery of healthcare services. Digitisation helps clinical practitioners to quickly and easily incorporate medical advancements into the treatment plans of patients.

Digitisation has helped healthcare systems address challenges thrown up by Covid-19 and will continue to redefine healthcare delivery systems. Many factors have contributed to the digital transformation of critical care -- a high demand for specialists, an urgent need for ICU beds, an increasing complexity of critically ill patients, the need for affordable and high-end critical care, better technological platforms, better connectivity to remote parts of the country and changing patient demographics.

Digitisation has also driven efficiencies in various processes of hospitals including:

Paperless record keeping: Called Electronic medical records (EMR), paperless record keeping has taken root in the medical field. Though at a nascent stage at present, the concept is evolving and routine record-keeping is transitioning to the e-format, which is expected, overtime, to include the whole gamut of record keeping.

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The purpose of EMR is to enable healthcare workers to spend quality time on clinical care, and not on documentation, as patient records from various sources will be available in e-format in the Hospital Information System (HIS).

Remote monitoring: Digitisation helps healthcare workers to overcome geographical barriers and monitor patients in remote areas. The patient may be at home, in the ICU, or in the wards. It helps a healthcare provider to stay connected with the patient even if the former is not present on site. This also helps monitor patients that have been discharged from ICU but need to be observed for sometime. The vitals of a patient can be constantly monitored with this device and accordingly alter treatment or intervention plans. A device driven by technology also minimises chances of human errors. In addition to the above, the device plays a significant role if a patient needs to be shifted to a hospital from the referral site. The remote monitoring system facilitates monitoring of the patient en route.

Home monitoring: The system makes it easier for doctors to monitor their patients at home after they are discharged from the ICU and for post-discharge follow-up. Covid provided an impetus to home monitoring systems. The platform not only helps in tele-ICU systems, but also in monitoring oxygen, heart rate, etc., while the patient is at home in isolation. This particular system enables doctors to easily monitor their patients who are in their recovery period rather than keeping them in the hospital for a prolonged period of time, freeing up precious hospital beds for other patients.

Artificial Intelligence (AI) in ICU: Critical care is a data-driven speciality. ICU care often demands instant processing of the available data to make split-second decisions. AI helps streamline protocols and processes including emergency protocols, which not only makes the system more efficient but also reduces human errors. Depending on the clinical context, AI can be programmed to trigger appropriate escalation matrix and clinical flow pathways as needed. Not only that, an early interpretation of data through AI helps the medical team pick up subtle warning signs and choose suitable treatment options.

Scoring system: Also called Advance Early Warning Systems, score has evolved in the ICU over the last decade. All patients that are admitted to hospitals for treatment are checked on a scoring sheet that includes basic physiological parameters like heart rate and temperature. The scoring system helps medical staff detect warning signs. Any worsening in the score, or any one of the parameters, gives an early warning regarding the deterioration of the patient’s clinical condition.

This system is extensively used in the ICU, general wards as well as in other areas. Even a small variation in the parameters can be detected through this system, which helps caregivers to act quickly and appropriately.

In short, digital technologies have significantly changed the way critical care units are designed. Tedious, repetitive tasks have been eliminated to lighten the workload of medical professionals and nursing personnel.

(The writer is Chairman, HOD & Consultant – Critical Care Medicine, at a Bengaluru-based hospital)