I worked for a rural hospital that had EICU. The tele-ICU allows rural areas to have access and treatment from critical care professionals by remote intensivists using technology like videoconferencing. Tele-ICU physicians can run codes, talk the care team through procedures, as well as speak directly to patients and/or their families to help with difficult care decisions.
Some advantages comes with tele-ICU such as another set of eyes on the patient from a command center reviewing charts, vitals, labs, and medications being inputted. The physician can turn on the monitor at any time and discuss care with the patient or patient’s family. Staffing tele-ICU allows increased efficiency and cutting staffing cost. Studies show that tele-ICU improves clinical outcomes, decreases mortality, shortens the length of stay, and increases staff readiness in changes for best practice. It also decreases the number of hospital transfers for specialty care, fewer families needing to drive long distance for care, and provide more care to rural areas.
The disadvantages of the tele-ICU are that command centers can be 1,000 miles away or in foreign countries which would leave the serious concern, “Is standard of care the same?” No backup plan available if tele-medical equipment malfunctions – who is responsible? Who will staff the unit? What will happen to the patient if an emergency comes about? If multiple interruptions or malfunctions occur the organizations would be at baseline without coverage. Tele-ICU could negatively impact the patient’s opinion on the facility due to the lack of patient-physician relationship, different patient experience, own lack of trust in telemedicine. A disadvantage would be could the information be jeopardize by hackers especially a high profiled patient. Since tele-ICU is different than other care particularly in terms of the risks to privacy and electronic storage and transmission of information should the patient be require to sign informed consent? If the patient doesn’t agree to tele-ICU should they be transferred to a big facility that has onsite ICU 24/7.
I believe technology helps improve healthcare all the time. Downfall to technology is having someone who knows what to do if technology fails. While searching for new technology in healthcare, I came across automated IV pumps (pumps connected the MAR and change automatically,) portable monitors, smart beds that track weight, vitals, and movement of patients, and wearable devices that track heart rates, exercise, sleep, respirations which help individuals to take their health into their own hands.
Some of the advancements seemed really useful and may help give nurses back time to spend with patients. I fear what would happen if something malfunctioned – would back up methods of care be available for nursing to utilize? Would this make hospitals more of target to have private health information jeopardized? Overall, I believe technology is great and does improve bedside nursing.
It’s been nearly a decade since I completed my BSN program. Upon graduation, I chose to work at a state-operated mental health facility. I quickly learned that we were always a few leaps behind privately-owned hospitals in regard to technology. In the facility, the electronic charting system was a fairly new development at that time. Some of the seasoned staff were still struggling to learn basic computer skills and electronic charting was foreign to them. The program that we used at that time was solely used for electronic summary and progress notes. Over the years, we transitioned to more modern technologies. The hospital obtained an electronic MAR system with built-in charting options. The MAR was implemented with barcode scanning capabilities, which when used properly was promised to aid in the prevention of medication errors. Our hospital began using electronic incident reporting and included the restraint/seclusion database in this incident reporting system to save the nurses a step. Our pharmacy purchased a state-of-the-art multidose packaging system for medication dispensing. With each change, staff were provided education to ensure competency. With the evolution from the paper-based charting system to the electronic medical records system, our facility has faced the challenge of multiple closed software programs that do not have information-sharing capabilities with other programs. The closed status of these programs is labor-intensive, as it forces hospital staff to double and sometimes triple document patient data (Lamo et al., 2016). An interoperable electronic medical record (EMR) would be helpful as it would help to standardize patient care, allow for seamless documentation of care provided, and would increase communication amongst healthcare providers (McGonigle & Mastrian, 2022).
An interoperable EMR improves patient care and safety by increasing communication and awareness of patient status amongst healthcare providers. This provides for faster identification of patient needs (diagnosis) and more efficient implementation of medical/nursing interventions. While this is a great benefit, it comes with risks as well. Cybercriminals work diligently to fraudulently obtain personally identifiable information of consumers and healthcare consumers are not spared. The HIPAA Security Rule was established to mandate that health care providers take necessary steps to protect patient data (Department of Health and Human Services, 2013). Federal laws also mandate health care organizations to disclose any data breaches to the patient(s) affected (Department of Health and Human Services, 2013). While these regulations guide healthcare providers to use mechanisms to prevent breaches of patient data, hackers continue to find ways to infiltrate various programs. With the evolution of technology, we must stay abreast of available security measures.