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Local care from a long distance

Posted: February 14, 2012 - 1:02am
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Photo courtesy of Bartlett Regional Hospital
Nurse Liesl Bland attends to “patient” Jennifer Chilton, who is actually a certified nurse’s assistant at Bartlett Regional Hospital. On the television screen are health care providers at Providence Hospital in Anchorage. A new service at Bartlett, called eICU, is expected to allow some critical care patients at Bartlett to remain in Juneau, instead of having to be medevaced to Anchorage or Seattle.

In 2010, 238 patients were transported to another medical facility from Bartlett Regional Hospital from January to November. The hospital has implemented a new program in its Critical Care Unit which would have allowed its staff to treat 37 of those patients locally.

The hospital has implemented an upgrade to its CCU, calling it an eICU (electronic Intensive Care Unit), and installed super high tech cameras on one side of seven rooms in the Grace T. & Henry I. Akiyama Critical Care Unit. Below the camera is a monitor and a big red alert push button. A nurse or a physician caring for a patient at Bartlett can push that big red button any time. Each camera and monitor is basically powered by an individual computer not visible in the room.

Not long after pushing the button, a person will appear almost like in a video conference on screen. That person will either be a certified critical care nurse or physician from Providence Alaska Medical Center in Anchorage. The physician is available from 9 p.m. to 7 a.m., while other health care providers trained in intensive care are available 24 hours a day, seven days a week.

In a demo for the Empire on Monday, CCU director Nancy White pushed the button.

Jean Marie Callens appeared on the video screen and rotated the angle of the camera to see the people in the room. As a test to demonstrate what she could see, a piece of paper was placed on the pillow of the bed across the room from the camera. Callens read the first paragraph.

"They can look at the pupils to see what size the pupils are," White said. "They can count respirations. They can really zoom in."

The person can also zoom in and see what's in the IV bag or anything else medical staff at Bartlett is using.

Callens also has a screen that will show monitored vitals for every person in those CCU rooms — provided Bartlett has asked for monitoring of all of the patients — and can focus that attention. Medical staff at Providence receive other written data and assist in monitoring the patients. Basically Providence can see everything the hospital has collected for a patient with a data telecommunication link — it just needs the name, medical number and room number for a patient.

The rooms also have a microphone, so that Callens or another person from Providence can hear whomever is in the room, and a speaker. White said the speaker volume is set at about the same level in each room so that the patient, medical staff and anyone else allowed in the room can hear what's being discussed.

White said this won't replace any nursing, physician or surgeon staff at Bartlett, but is intended to enhance the care given. One way the system can be used is if a nurse at Bartlett needs to check on one patient, but someone should also be monitoring a second. That nurse can push the red button and ask Providence to watch patient ‘A,’ letting them know she will be in a specific room number for patient ‘B.’ Providence will monitor patient ‘A,’ and if that patient needs attention before the nurse gets back, Providence can contact her in the other patient's room directly.

Another use allows physicians at Bartlett to consult with a physician at Providence about a specific patient's care. Nurses could also use it to ask questions for something they may be uncertain about.

Bartlett said that from Jan. 1 to Nov. 11 in 2010, 238 patients were transported to another facility. Based upon research the hospital did, it found 37 patients who could have been treated either definitely or for a longer duration at Bartlett with the assistance of the eICU.

White said this does not prevent them from medevacing people out, but it can provide more patients with the ability to receive care locally. White said it gets to be expensive for a patient and their families when patients have to be transported out.

The addition of the eICU will not add costs to patients.

The cost to the hospital, White said, is $280,000 for start up and will be $80,000 annually.

White said Bartlett started evaluating the option after Nursing Director Cathy Carter went to a conference and learned about it. The hospital researched the program and is collecting data to evaluate it as it goes along.

White said if a patiently was adamantly opposed to the video camera monitoring, staff would explain to them the benefits of using it. If they were still adamantly opposed the hospital would respect their wishes.

"We started Feb. 4, we’ve been monitoring two patients 24/7, except today we’ve only got one patient on," White said. "We’ve got a lot of positive feedback from the nursing staff and the physicians. None of our patients so far have said, so far, ‘don’t turn the camera.’ ... We’re really excited to move forward with this. We think it’s an added benefit for our community."

Aside from monitoring its own services, Providence also provides this kind of care for Providence Kodiak Island Medical Center and the Providence Seaside Hospital in Seaside, Ore.

• Contact reporter Sarah Day at 523-2279 or at sarah.day@juneauempire.com.

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Latitude58
14383
Points
Latitude58 02/14/12 - 08:08 am
0
1

Oh really?

"White said this won't replace any nursing, physician or surgeon staff at Bartlett, but is intended to enhance the care given. One way the system can be used is if a nurse at Bartlett needs to check on one patient, but someone should also be monitoring a second."

Seems to me that if there are two really sick patients, then perhaps there should be two nurses. Sounds like this is a way to minimize staff.

If I'm patient 'A', I'll take the real, live nurse, thank you very much.

Ak_Mom
1042
Points
Ak_Mom 02/14/12 - 08:59 am
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1

here's a thought

Why don't we hire local certified critical care nurses to work and have local physicians here? I would rather be airlifted out at my own cost to a hospital with real human stall than electronic staff!

Can the electronic staff also perform CPR? Wipe away a tear? Hold a scared hand?
If BRH has the money for fancy electronic equipment than they should be hiring more specialized staff. Like IV Specialist for children. ((( That's another long rant )))

fireguy
348
Points
fireguy 02/14/12 - 09:24 am
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1

Latitude 58 and AK Mom are

Latitude 58 and AK Mom are right on the money. The way that is written, it does replace a nurse. I would not want to lay there and know there is a video camera on me 24/7.

messiahofmetal
2
Points
messiahofmetal 02/14/12 - 10:10 am
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1

What is the scope of this eICU care?

I'm curious to what scope of care this eICU will allow staff at Bartlett to cover, just get some damned ccrn's and a qualified physician, we pay enough damned money for that hospital as it is.

countthis
477
Points
countthis 02/14/12 - 10:11 am
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"The addition of the eICU

"The addition of the eICU will not add costs to patients."

Yeah right, in a pig's eye, that's laughable. No hospital is going to spend that kind of money and not pass it along to the patients. Do they really think we are that stupid? I also agree with all the other comments, this borders on creepy, get me a real nurse or a doctor when I need one and not some eye on the wall. How many CCU nurses could they have hired for that kind of money?

mommcat
16
Points
mommcat 02/14/12 - 12:32 pm
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1

Physician available from 9pm to 7am.

What if you need a Dr. from 7am to 9pm.

JuneauAlaska
84
Points
JuneauAlaska 02/14/12 - 01:49 pm
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1

Missing the point

I think everyone is missing the point. This is in ADDITION to the intensive care PROVIDED BY CRITICAL CARE NURSES AT BARTLETT. And their LOCAL DOCTOR.

countthis
477
Points
countthis 02/14/12 - 02:17 pm
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1

we are not missing the point JuneauAlaska

It would just give the hospital/hospitals an excuse to double bill us for services from two hospitals rather than one. No thank you. If Bartlett doesn't have the competant trained help to monitor my care with onsite nurses and doctors then send me south. Notice according to the article they interviewed hospital staff only not patients, and then stated if patients objected they would have an explanation from staff why it was benefial for " staff" and then be given a choice. Anyone that has ever spent anytime in CCU is highly medicated and not really in a position to make such decisions for themselves. Sounds like an aweful lot of arm twisting to justify someone spending an arm and a leg on some fancy web cam system and not just hiring more ccu nurses/doctors and support staff here at Bartlett.

My2cents
32
Points
My2cents 02/14/12 - 04:45 pm
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1

BRH seriously lacks.

For 6 months I took my husband to the ER at BRH. He was 6’1 and about 120 soaking wet. He had headaches constantly. Long matted hair from laying in bed all day. The ER would give him one dose of pain meds and send him home. Probably thought he was some sort of drug seeker. After about 6 months and several ER visits, my husband collapsed. He had thyroid problems (the weight loss was a sign). This caused problems with his heart. During all this, low and behold, an MRI revealed a MASSIVE brain tumor. (The cause of his headaches).
His regular doctors are at Providence (the neurosurgeon) and AK regional (oncologist). If we can now go to BRH and have direct correspondence with Providence, I will be a little more at ease going to BRH. BRH seriously lacks.

Ak_Mom
1042
Points
Ak_Mom 02/14/12 - 05:58 pm
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1

@My2Ccents

Same with my daughter for years we took her to drs and ER for what they called migraines that started when she was 09... by 12 she was literally on deaths door when they finally did an MRI found a massive brain tumor and sent her to children's with zero hope of survival.
I don't know what they ere thinking that a 9-12yr old was a drug seeker? But took until she couldn't walk before they bothered to look. Needless to say all care goes to Seattle now. And since the dr's here also missed my other daughter's cancer. I don't think any amount of technology will get me to trust BRH anytime soon.

Latitude58
14383
Points
Latitude58 02/14/12 - 08:10 pm
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1

My2cents and AK_Mom

So very sorry to hear about your losses.

Unfortunately, by the sounds of this article, neither of your loved ones would have been helped by this technology since it's only deployed in the CCU, not the ER. So unless they had been admitted into the CCU, the Providence staff would never have seen them.

Perhaps in the future the ER will have a booth that you enter and some remotely controlled drone nurse will make you say 'ahh' and bend over.

My2cents
32
Points
My2cents 02/14/12 - 11:12 pm
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1

Latitude58

Jumping to conclusions. I don't say or hear anything about losses. My husband is still fighting brain cancer. 2 Sugeries later and currently doing chemo, here at Juneau. Since initial diagnosis, he had been in CCU. That was before this new technology. If we end up there again, we will be able to have contact to Providence.This technology will be great for us to connect to Providence if anything unexpected happens.

JuneauAlaska
84
Points
JuneauAlaska 02/15/12 - 12:04 am
0
1

Yes you ARE MISSING THE POINT

Yes you ARE MISSING THE POINT count this. The patients DO HAVE CRITICAL CARE NURSES AND A DOCTOR AT BARTLETT.
This new technology would be an extra set of eyes/ears, experts to consult with. What's wrong with that?! Some of you commenters on here just [filtered word] and whine about everything of which you know nothing, or little about.

AH HA
1636
Points
AH HA 02/15/12 - 10:57 am
0
1

AH HA

One thing that is wrong with it is that this is a giant privacy issue. Personally, I would prefer not to have a digital video recording my stay in a hospital. If I need more care than Staff at BRH can provide then perhaps it it time to be sent to a different facility.

JuneauAlaska
84
Points
JuneauAlaska 02/15/12 - 07:53 pm
0
1

Patients have a CHOICE

The patient would have A CHOICE. Also, there are times when a Medivac is not possible due to bad weather. There are times when this technology could be useful.

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