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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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