Health Informatics and Its Role in Critical Care Units

Vital Sync and the Future of Critical Care

We work hard to help you provide better patient care while managing costs. And we also know that becomes particularly challenging when dealing with critical care patients who require continuous, intensive monitoring.

Typically receiving care in the ICU or recovery unit, these patients require teams of clinicians to track and treat complex conditions. The patient spectrum ranges from those who need invasive mechanical ventilation to those at risk of unrecognized deterioration. Providing optimal care involves ongoing monitoring and coordinated, timely clinical decision-making. 

Efficiency Challenges Increase Risk for Critical Care Patients

Our goal is to help you detect, diagnose, and treat high-risk patients early — to avoid preventable complications. Hospital systems, however, may not have enough clinical staff to individually monitor these patients as closely as needed to catch those early warning signs.

In a recent survey, nearly 90 percent of physicians reported spending less than 60 percent of their time on direct patient care — despite well-intentioned investment in staffing.1

In the ICU and recovery unit, that gap could mean the difference between complication-free care and recovery or adverse and costly outcomes.

An estimated 1.2 million patients are on mechanical ventilation in the ICU every day in the United States.2 While this therapy is critical in helping patients recover to natural breathing, it also can cause the respiratory muscles to atrophy over time, acute lung injury, or infection risk. And about 420,000 patients experience adverse events related to ineffective weaning, costing hospitals $7.9B, of which $5.7B is preventable.2

In less acute settings such as the recovery floor, the prevalence of sicker patients is increasing. These patients can be at risk for respiratory compromise, the second-most frequent preventable safety issue in the United States. The use of medication to control postoperative pain contributes to this high incidence,3 as about 13 million patients use patient-controlled analgesics (PCAs) annually.4 The Healthcare Cost and Utilization Project undertook an analysis of national inpatient costs in 2013. They determined that respiratory failure, insufficiency, and arrest combined was the 12th most expensive condition treated in U.S. hospitals, totaling $7.1 billion in 2013.5

Related: Learn more about the impact of respiratory compromise. Read this blog post.

Preventing the Preventable

We believe data and analytics play a key role in facilitating early detection and treatment for critically ill patients to preventing the preventable. This evolving perspective has benefited from significant advances in the technology ― and it brings a shift that many hospitals are navigating day to day.

“There isn’t anything coming into our system now that isn’t somehow connected to IT,” says Mark Daniels, Chief Technology Officer at Medical University of South Carolina. “The earlier we’re involved, the better off our partners are on a project.”

And the amount of data available to you continues to expand.

“We’ve now passed the era of implementing electronic health records,” says Dr. John Chelico, Vice President, Chief Informatics and Innovation Officer, Northwell Health. “Patient portals, wearables like smart watches, and other sources of data can really help us understand the full view of the patient.”

But data alone is not enough. Providing you with the right information, for the right patient, at the right time, is paramount in critical care settings. When data is translated into an actionable insight, it can drive significant, meaningful, and relevant results for clinicians and patients.

Artificial intelligence, advanced algorithms, and predictive analytics all can be used to aggregate discrete data into actionable insights for clinicians. With today’s technology, we can collect huge amounts of data from electronic health records, monitoring systems, and therapies. And we can then integrate it into dashboards, alerts, or other reporting mechanisms to help you make timely decisions.

For postoperative patients at risk for unrecognized deterioration, better monitoring and early intervention may help prevent in-hospital decline by addressing evolving respiratory compromise.6,7 For mechanically ventilated ICU patients, continuous monitoring and protocol-driven tools can help wean patients off the ventilator sooner. Protocolized weaning has been shown to allow clinicians to wean patients more than a day earlier and reduce ICU length of stay by up to 11 percent.8

With this technology, you receive integrated real-time data anytime, anywhere, so you can monitor multiple patients at once via mobile devices. And you receive earlier notification, so they can treat the patients who need it most. Given the ongoing staff-to-patient ratio challenge, these insights can also help improve efficiency and clinical workflow.

“The more I’m able to bring together data from disparate systems and serve it up to clinicians in a meaningful and actionable way ― in near real-time ― the more value it adds,” says Daniels.

Related: Learn how early warning scores may help prevent the preventable.

IT Solutions for Coordinated Care

We offer a portfolio of health informatics and monitoring solutions for hospitals. These solutions can help clinicians collaborate on patient care and work at optimal efficiency. The software platform and clinician decision support tools have been designed to help reduce never events,9 length of ICU stays, and code blues.10

Related: Watch a video about how the platform works.

IT Solutions for Coordinated Care

Collaborating for the Future of Healthcare

IT experts widely recognize the role of data in improving patient outcomes and system efficiencies. But implementing the tools and solutions to realize that data’s full potential is a step-by-step process.  

“Dedicated time and resources are required to create a true data science platform,” says Chelico. “As a healthcare IT leader, you have to paint a picture of what the future will look like to influence stakeholders about the benefits.”

With our device technology and value-based healthcare offerings, we are positioned to be an active partner in the value-based transformation. But we cannot do it alone. Strong partners have a shared vision. They bring focused teams with vast capabilities and competencies. And they commit to quality, process, and structure.  

To facilitate collaboration across the industry, we frequently host IT Advisory Board meetings around the globe. Hospital CIOs and CTOs are invited to discuss challenges, share opportunities, and explore potential solutions that could deliver short- and long-term benefits to you and patients alike. Our experts are on hand to provide insights into the role our technology — both current and future — might play in leveraging data to its fullest potential. Chelico and Daniels both attended a recent meeting held in Minneapolis.

“The value of data is constantly increasing,” says Daniels of the opportunities ahead. “Part of that comes through trusting the data and its source. The value in data aggregation, drawing it from different domains — patient, device, predictive analytics — comes from the insight and knowledge we gain that didn’t exist before.”

“I see Medtronic as a partner in how we will practice medicine for the next 50 years,” adds Chelico.

Ready to learn more? Contact us today.

References
1. Christino MA, Matson AP, Fischer SA, Reinert SE, DiGiovanni CW, Fadale PD. Paperwork versus patient care: a nationwide survey of residents' perceptions of clinical documentation requirements and patient care. J Grad Med Educ. 2013;5(4):600–604. doi: 10.4300/JGME-D-12-00377.1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886458/ 
2. Healthcare Cost and Utilization Project (HCUP). National Inpatient Sample Database, 2014: Internal Analysis.
3. Quality Matters: Tackle the Top 3 Patient Safety Issues. Healthgrades Website. https://www.hospitals.healthgrades.com/index.cfm/customers/e-newsletters/april-2013/quality-matters-tackle-the-top-3-patient-safety-issues/. Accessed July 11, 2016.
4. Stoelting R. Anesthesia Patient Safety Foundation presentation. Patient, Safety Science & Technology Summit; January 2013.
5. Torio CM, Andrews RM. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013. Agency for Healthcare Research and Quality Statistical Brief #204. May 2016. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.pdf. Accessed September 9, 2018.
6. Sun Z, Sessler DI, Dalton JE, et al. Postoperative hypoxemia is common and persistent: a prospective blinded observational study. Anesth Analg, 2015;121(3):709–715.
7. Taenzer AH, Pyke JB, McGrath SP, Blike GT. Impact of pulse oximetry surveillance on rescue events and intensive care unit transfers: a before-and-after concurrence study. Anesthesiology. 2010;112(2):282–287.
8. Blackwood B, Burns KE, Cardwell CR, O'Halloran P. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev. 2014(11):CD006904.
9. Slight SP, Franz C, Olugbile M, Brown HV, Bates DW, Zimlichman E. The return on investment of implementing a continuous monitoring system in general medical-surgical units. Crit Care Med. 2014;42(8):1862–1868.
10. Brown H, Terrence J, Vasquez P, Bates DW, Zimlichman E. Continuous monitoring in an inpatient medical-surgical unit: a controlled clinical trial. Am J Med. 2014;127(3):226–232.

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TOPIC: Vital Sync™Intensive Care Unit

About the Author

Robert Bell

Robert Bell is a registered nurse with more than 24 years’ experience in health information technology with several large medical software companies.

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