Big hospitals adding remote monitoring for ICU patients

Residents are split on whether e-ICUs, meant to enhance patient safety, rob physicians-in-training of their autonomy.

By Myrle Croasdale, AMNews staff. Sept. 17, 2007.

When resident Neha Vagadia, DO, first heard her hospital was going to install an e-ICU system, the prospect of a video camera in every intensive-care patient's room seemed intrusive.

Having a physician in another location watching her patient's vital statistics, lab results and other data left Dr. Vagadia wondering if she would be constantly second-guessed.

"I was extremely nervous about having someone always looking over my shoulder," said Dr. Vagadia, chief internal medicine resident at the University of Massachusetts Memorial Medical Center.

To date, e-ICU systems have been adopted at seven academic medical centers, according to VISICU, which appears to be the only company that sells this type of system. Overall, more than 200 hospitals use it to monitor 250,000 patients a year.

The introduction of electronic and video monitoring of hospitals' sickest patients has physician educators concerned.

Though only a small number of teaching hospitals have e-ICUs, more are likely to adopt them as patient safety initiatives and physician shortages build, physician educators said.

Critics caution that e-ICU systems will stunt residents' sense of independence, which is critical to their development as physicians. Supporters say that the monitoring gives residents easy access to a second opinion and ensures that the most vulnerable patients get the best care possible.

"Patients should not suffer for residents to train," said Craig Lilly, MD, e-ICU director at the University of Massachusetts Memorial Medical Center. And residents should be able to leave the hospital without wondering if they made the right decision for an unstable patient.