Riverview’s Tele-ICU Enhances Critical Care

March 10, 2017
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Judy Surko, ICU nurse manager, and John D. Royall, M.D., medical director of  Riverview’s ICU, confer with Jeffrey Sadowsky, M.D., medical director for Critical Care Medicine at InTouch through the tele-ICU robot. Photo: Nikole J. Ghirardi

By Judy O’Gorman Alvarez

RED BANK ­– Beginning this week there’s a new doctor in the Intensive Care Unit at Riverview Medical Center. And this one may have the training, certification and even bedside manner of your favorite intensivist – a critical care physician – but the five- and-a-half -foot physician needs no vacations, sick days or even coffee breaks. Instead he gets his juice from a power charger plugged in beside the main ICU desk.

The new tele-ICU combines videoconferencing and image sharing technology in the form of a robot that works alongside the highly trained critical care team.

A robot, with a flat screen on the head, connects with a remotely located intensivist who can examine a patient, evaluate symptoms, access all clinical data and prescribe medications as needed. The patient and family members, including those who are not there in person, as well as the on-site ICU team, have simultaneous direct visual and auditory communication with the physician.

This will act as the “eyes and ears” of the intensivist, according John D. Royall, M.D., a pulmonologist and medical director of the Riverview ICU.

ohn D. Royall, M.D., and the tele-ICU robot check in on a patient in Riverview Medical Center’s Intensive Care Unit.

Royall said the tele-ICU is not intended to replace clinicians or highly skilled critical care team, and an on-site Riverview-based intensivist can be called in at any time.

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“The reality affecting hospitals across the country is that a critical care specialist is not always immediately available when a patient is most in need,” said Royall. “By utilizing the tele-ICU robot, a board-certified intensivist is always immediately available, which offers improved safety and care for our patients.”

The five board-certified intensivists assigned to Riverview Medical Center live in various cities throughout the U.S. but at a moment’s notice their eyes and ears are on the patients in Red Bank.

Patients and their families can converse with the doctor – in real time – ask questions, review diagnostics. The robot can “zoom in” for a closer look at the patient and, with the aid of a live pair of hands from accompanying staff, listen to the patient’s heartbeat.

The offsite intensivist can direct the robot to the bedside to observe a patient and react immediately if there is a change in the patient’s vital signs.

“Because of the severe illnesses which characterize the patients in the ICU, rapidly changing clinical conditions are the norm,” said Royall. “The tele-intensivist, via the robot, becomes a second set of eyes to provide additional surveillance and support.”

The tele-intensivist will make its morning rounds with the nurse practitioner on duty to get to know the patient, followed by multidisciplinary rounds at 10 a.m. “Then at 10 p.m. he’ll beam back in and communicate with the charge nurse and go around with the bedside nurse,” said Royall, to review and formulate plans for the morning.

“It’s phenomenal,” said Judy Surko, nurse manager, who along with the staff is excited to be working with the groundbreaking technology.

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The tele-ICU will be “assessing and monitoring,” said Surko. “This is the true critical nature that happens in ICU.

“This is especially helpful during the late shift,” she said, “in the late evening or during the night when a critical patient comes in.”

According to Surko it may reassure the patient’s family, too. “It’ll help ease the family to know that someone is on top of the patient continuously.”

Although a “name the robot” contest is planned, Surko said around the floor they affectionately refer to it as Rosie, as in the robot housekeeper on the 1960s cartoon “The Jetsons.”

The tele-ICU has other benefits as well. “What also appeals to us is it doesn’t disrupt the current doctor-patient relationship that exists already,” said Royall. “Our sickest patients have critical care physicians who they already see, and every one of our doctors has an office practice.” This will cut down on summoning physicians to the hospital to check on patients.

Each year, it is estimated that nearly 6 million patients are treated in ICUs. With an aging population in need of critical care services, ICUs are identifying new and improved methods for providing the best care possible for their sickest patients.

Riverview Medical Center’s tele-ICU will provide a critical support system to the patient care demands in the modern ICU.

“We’re hoping this will be a big collaboration,” Royall said. “It’s a win-win.”




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