Overcoming the Shortfall of Intensive Care Workforce through Systematic Implementation of Centralized Patient Monitoring and Virtual ICU Solutions

Growing Complexity in the High-acuity Care Environment

The high-acuity care environment is dynamically changing globally, especially with regard to operating rooms, intensive care units, and their workforce. The growing shortfall of intensive care workforce is challenging the ability of hospitals to care for critically ill patients. There is a growing need for intensivists and trained nursing staffs to care for critically ill patients in acute care settings. In many countries, a shortfall of intensivists poses a real challenge; there is either a short supply or they are entirely absent, with workloads being shared by non-trained hospital personnel. This is an alarming situation in the healthcare sector as young physicians and nursing professionals are not willing to take on the long, demanding hours of critical care specializations. This is due to factors such as increased liabilities, stressful work environment, and difficulty in providing uninterrupted patient care during emergencies. However, the magnitude of the shortfall is difficult to determine in various countries due to the lack of national data on intensivists’ practices and resource allocations. It is quite evident that expert care from specialists can improve patient outcomes and shorten hospital stays, thereby reducing costs and minimizing hospital stay and readmissions.

In the United States, a recent Health Resources and Services Administration report in collaboration with the American College of Clinical Pharmacy (ACCP) estimates that by 2020, there will be a shortage of more than 1,500 critical care physicians as the nation will need at least 2,600 or as many as 4,300. But the current supply of 1,900 intensivists is expected to only grow to 2,800 by 2020, which is not likely to meet industry demands. In the United Kingdom, the National Health Service (NHS) grapples with staff shortages and intensive care units often struggle to maintain adequate staffing levels, with a few NHS trust hospitals even running out of intensive care beds as many patients needing treatment for life-threatening critical conditions. This illustrates the need for more intensivists on the field. Many countries globally are facing similar circumstances and there is a dire need to address this challenge.

Connected Devices and Advanced Informatics can help address Intensivists Shortages

As an alternative for critical care delivery models, hospitals can leverage electronic medical/health record (EMR/EHR) systems and medical device connectivity solutions to overcome shortages of intensivists in the high-acuity care environment. Medical devices compliant with the healthcare enterprise (IHE) patient care device (PCD) can establish connectivity with the enterprise hospital network for sharing patient generated data. A centralized patient surveillance platform offering end-to-end medical device connectivity acquiring patient data in real time, intelligent clinical alarm systems with advanced analytics, a clinical-decision support system (CDSS), and a virtual ICU solution can address the challenges in the intensive care environment. Bi-directional communication between connected medical devices and clinical information systems (CIS), particularly for smart infusion pumps programming and multi-parameter patient monitoring has proven to prevent adverse events in the high-acuity care environment. A well-integrated system with a centralized clinical dashboard with real-time insights on patients can help intensivists by prioritizing patients that require maximum care.

False Alarms create Alarm Fatigue in the High-acuity Care Setting

Many hospitals have expressed concerns about frequent alarm triggers that result in alarm fatigue for intensivists and nurses, who are unable to prioritize alarms for immediate attention to high-risk patients. False alarms in the high-acuity care setting often consume quality time of the intensive care workforce. Vendor-agnostic medical device connectivity solutions combined with smart clinical alarms can streamline alerts by filtering unwanted alarm triggers through built-in algorithms. Most of the clinical alarms produced by standalone PCDs rely on default parameters set during the installation or by individual clinicians that are mostly independent of other devices connected to patients. Medical device connectivity solutions help clinicians consolidate data from multiple devices connected to patients and provide clinical insights based on the parameters set by clinicians specific to each patient condition. As all medical devices and clinical information systems (CIS) are connected under a single technology platform, intensivists can tailor alarm settings specific to each patient needs from a centralized workstation without having to visit each room and manually adjust the device thresholds for all the devices in the care setting.

Early Warning Scoring System (EWSS)

The early warning scoring system helps clinicians quickly determine the degree of illness of a patient, at times used as a track and trigger response system. A connected devices ecosystem can offer a platform to implement EWS systems and automate the process without requiring manual interventions. EWS is based on the data aggregation of six vital signs such as respiratory rate, SaO2, temperature, blood pressure, heart rate, and AVPU response. Medical device connectivity solutions will encourage providers to incorporate more clinical assessment parameters into their routine care for assessing patients at the bedside. Three new parameters can be included with existing parameters such as pain, level of consciousness, and urine output for clinical decision making. This consistent process would set a baseline for data that could be used for larger big data efforts and population health management.

Virtual Intensive Care Units (eICU) for Continuous Patient Surveillance and Monitoring

Hospitals can leverage vendor-agnostic medical device connectivity solutions to implement virtual continuous patient surveillance systems for addressing intensivists’ shortages and taking telemedicine initiatives that improve patient experience. Virtual ICU systems use latest digital health technologies equipped with clinical surveillance capabilities, real-time access to patients’ physiological data, waveforms, clinical alarms, alerts combined with EMR/EHR, and a two-way communication system embedding audio and video capabilities to monitor patients across multiple locations. This addresses the scarcity of intensivists in high-acuity settings. Indeed, a fully integrated solution spanning software, gateways, and bi-directional connectivity will be much more efficient in driving clinical, operational, and financial value in a healthcare enterprise.

Frost and Sullivan’s new research report on Global Medical Device Connectivity Market, Forecast to 2022 provides a comprehensive analysis on the global medical device interoperability market with a competitive landscape covering clinical information technology (IT) systems vendors, medical device original equipment manufacturers (OEMs), vendor-agnostic third-party medical device data systems (MDDS) vendors, and healthcare system integrators. Please reach out to us to know more about medical device interoperability solutions and the numerous methods to establish connectivity of your medical devices with the hospital network regardless of device types.

Dinesh Kumar | Industry Analyst-Transformational Health-Europe | Frost & Sullivan dineshk@frost.com

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For six decades, Frost & Sullivan has been world-renowned for its role in helping investors, corporate leaders and governments navigate economic changes and identify disruptive technologies, Mega Trends, new business models and companies to action, resulting in a continuous flow of growth opportunities to drive future success.

Frost & Sullivan

For six decades, Frost & Sullivan has been world-renowned for its role in helping investors, corporate leaders and governments navigate economic changes and identify disruptive technologies, Mega Trends, new business models and companies to action, resulting in a continuous flow of growth opportunities to drive future success.

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