Critically ill NHS patients are to be monitored via video link by doctors in a central contol room for the first time in Britain as part of a new scheme aimed to improve out-of-hours care.
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The project uses high definition cameras to allow consultants to check on patients’ conditions from a centralised control room, from where they will then be able to alert and advise bedside teams if action is required. It is hoped the scheme will improve the standard of care at nights and weekends, when wards are typically staffed by junior doctors.
However, it has raised safety fears and critics have described it as a “doctor-led” rather than “patient-led” response to the problem of poorer quality out-of-hours care.
However, it has raised safety fears and critics have described it as a “doctor-led” rather than “patient-led” response to the problem of poorer quality out-of-hours care.
The “eICU” scheme is being trialled by Guy’s and St Thomas’ NHS Foundation Trust – which operates two hospitals in central London. The initial £2.85 million cost has been met by a grant from the trust’s charity. The project will see a control room established at St Thomas’, from which patients at Guys, around a mile away, can be monitored.
Dr Richard Beale, clinical director of perioperative, critical care and pain services at Guy’s and St Thomas’, said: “It’s like an airport having a control tower, supporting what is going on throughout the system, so that the overall quality goes up and senior people are available when needed.”
The cameras are so powerful that they can detect whether the pupil in a patient’s eye dilates to bright light. Patients will also be “wired up” to a series of monitors programmed to raise the alarm if their condition suddenly changes.
The computer hardware will take around nine months to install. There will then be a two to three year trial, involving patients in high dependency and critical care wards, including those caring for stroke patients and those admitted to accident and emergency after “trauma” injuries. It will initially provide care cover to 65 beds, but could expand to 120. If successful, the system could be rolled out to other London hospitals, and taken up by others further afield. It could eventually allow consultants to log on at home to check on the condition of patients.
The system is already in use in more than 300 hospitals in the US, where the Philips “telemedicine” technology is said to have cut patient death rates by 27 per cent and hospital stays by 23 per cent. This is the first time it has been introduced in Europe.
Dr Brian Rosenfeld, chief medical officer for telehealth at Philips, said the system allowed an intensive care doctor to oversee up to 150 beds. He said: “That is a huge improvement in productivity. The potential cost reductions are really myriad. We are able to identify clinical changes earlier than most clinicians are able to pick them up.
“If you depend on your bedside team to identify that there is a problem, then you are in a reactive care mode. What we have tried to do is change that to a proactive care mode.”
However, Roger Goss, co-director Patient Concern, said: “All technology is fallible and if the system breaks down, you are going to have an even more serious problem than you do now. If the system goes down, the unlucky patient in the wrong location, is going to be in serious trouble.
“It is a doctor-centred response to a problem, rather than a patient-led one. It is an attempt to fend off people complaining that hospitals are understaffed out of hours. If there is a problem identified in the evenings and weekends, then why don’t doctors treat medicine as a 24 hour profession?”
The system is already in use in more than 300 hospitals in the US, where the Philips “telemedicine” technology is said to have cut patient death rates by 27 per cent and hospital stays by 23 per cent. This is the first time it has been introduced in Europe.
Dr Brian Rosenfeld, chief medical officer for telehealth at Philips, said the system allowed an intensive care doctor to oversee up to 150 beds. He said: “That is a huge improvement in productivity. The potential cost reductions are really myriad. We are able to identify clinical changes earlier than most clinicians are able to pick them up.
“If you depend on your bedside team to identify that there is a problem, then you are in a reactive care mode. What we have tried to do is change that to a proactive care mode.”
However, Roger Goss, co-director Patient Concern, said: “All technology is fallible and if the system breaks down, you are going to have an even more serious problem than you do now. If the system goes down, the unlucky patient in the wrong location, is going to be in serious trouble.
“It is a doctor-centred response to a problem, rather than a patient-led one. It is an attempt to fend off people complaining that hospitals are understaffed out of hours. If there is a problem identified in the evenings and weekends, then why don’t doctors treat medicine as a 24 hour profession?”
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