The Eastern Oklahoma VA Health Care System (EOVAHCS) https://www.muskogee.va.gov serves veterans in a 25 county region with facilities in Tulsa and other rural communities in the state. EOVAHACS and the Cincinnati VA Medical Center’s https://www.cincinnati.va.gov tele-ICU Monitoring Center have partnered to help veterans in Oklahoma in the ICU and the emergency department have access to 24/7 remote patient monitoring.
Eleven ICU rooms and three emergency department rooms at EOVAHCS have teleconferencing equipment. Critical care nurses use this equipment to connect to providers to the Cincinnati VA Medical Center. This service is provided via teleconferencing, so that providers can access patients’ bedside data, video conference with patients, provide consultations, and communicate with clinical staff when faced with medical emergencies.
When a tele-ICU provider virtually enters a room, the camera turns to face the patient so that the provider and patient can see each other and communicate. The camera turns away when the teleconferencing sessions ends.
Results show that from June 2017 to March 2018, there were 5,155 video assessments performed on ICU patients at EOVAHCS by tele-ICU staff. This has resulted in over 140 hours of added assessment time by either an Intensivist or Certified Critical Care RN.
An example of this program’s success occurred in June 2018. A patient came to the emergency department with an acute stroke. Normally, the staff would use a tele-stroke tablet but couldn’t get it to work.
The next step was to contact a tele-ICU provider who then evaluated the patient’s symptoms and helped the onsite provider decide the best course of action. The tele-ICU provider helped to speed up the patient’s treatment and increase the patient’s chance for a successful recovery.
One of the challenges is that the emergency department staff are not always using the remote patient monitoring when they have onsite providers available. Also, the technology has had multiple challenges in terms of connectivity issues. To address this, the facilities schedule downtime for the system without interfering with patient monitoring.