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Banner Health eICU Shortens Hospital Stays, Improves Patient Care

eICU telemedicine nurse and patient

An ICU nurse at North Colorado Medical Center in Greeley checked in on one of her patients. He was on a ventilator and his vital signs all looked fine. But the nurse had a feeling something was wrong. She contacted the Banner doctor who also was monitoring the patient from more than 800 miles away.

Physicians and nurses with Banner’s eICU™ operations center, known as iCare, located in Mesa, Arizona, monitor ICU patients in 430 ICU beds in 20 Banner hospitals across five states. The iCare team is not replacing the nurses and physicians at the patients’ bedside, but backing them up.

Together, the bedside nurse at Colorado Medical Center and the eICU doctor began assessing the patient. Stat lab tests and X-rays were ordered.

Suddenly, the patient started to crash.  The X-ray arrived, showing a tension pneumothorax filling his chest with air. Without immediate treatment, it could be fatal. A hands-on physician was needed, but there were two codes in the emergency department and three surgical cases in process. The only available physician was a family medicine resident, on his first day in the ICU.

The eICU doctor talked the resident through the steps of inserting a needle into the patient’s chest to relieve the built-up pressure. The patient immediately began to breathe easier, and his oxygen saturation moved out of the danger zone. When a surgeon finished her OR case, she came down and inserted a chest tube. 

“The patient was discharged two days later,” says Deborah Dahl, Banner’s vice president for patient care innovation. She oversees Banner’s telemedicine operations.  

“This is an example of why I love coming to work in the morning,” Dahl says. “We not only have the opportunity to change the way health care is delivered, and at Banner Health, we are taking full advantage of that opportunity.”

In February 2006, Banner became one of the early adopters of Philips eICU technology. Over the past two years, Banner’s ICU mortality rates have been among the lowest in the country, Dahl says. In 2012, ICU actual length of stay was 20,000 fewer days than predicted, based on patient acuity; and total hospital days were reduced by 49,000. Costs avoided:  more than $68 million.

Each of Banner’s ICU rooms is equipped with a fixed two-way audio-video system. The bedside monitor sends real time continuous vital signs to the Philips system, while the electronic medical record interface sends lab results, medication orders, and other pertinent information from the bedside to iCare.  

The eICU technology can recognize a possible adverse trend and alert the iCare team member who is monitoring that patient. For example, if a patient’s heart rate goes up from 70 to 74 to 78, that’s within normal limits. But, as Dahl explains, “The eICU system says, ‘Hmmm. The heart rate is drifting up, the blood pressure is drifting down, there may be something going on here.’ The system does a rapid analysis and alerts the nurse or physician that there may be a problem.

Dr. Bhavish Shah, a critical-care specialist who spends one week a month in iCare  – the rest of the time he’s in his home state of New Hampshire – considers iCare state of the art.

“In the hospital, I can follow 10 patients a day,” Shah says. “Here I can follow 400. In iCare, my role is to respond to requests for help from the bedside, look for adverse trends and intervene before those adverse trends become adverse outcomes. We want every patient to receive the evidence-based practices they need.”

About the Author

Jane Erikson's picture

Jane Erikson joined the staff of the Arizona Telemedicine Program in April 2013. She was already familiar with the program, as she previously wrote about the program during her nearly 20 years of covering health care for the Arizona Daily Star in Tucson. Jane has lived in Arizona most of her life and is a graduate of the University of Arizona.


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