Dr. Marshall Lee, TeleICU medical director at Oregon Health & Science University, uses Mural Virtual Care Solution to see data in real time and work jointly with bedside teams in remote locations. (Courtesy, OHSU)
Oregon Health & Science University has entered into a multi-year agreement with GE Healthcare to set up the first virtual intensive care unit program in the state. The program aims to extend the academic medical center’s critical care expertise across rural communities and to help ensure the state’s ICU bed capacity is being used to its full extent amid the Covid-19 pandemic.
As Covid-19 cases surge across the country, adequate ICU bed capacity has become a highly sought after commodity. Severely ill Covid-19 patients often require critical care in ICUs, and overwhelmed hospitals are rapidly deploying technology, including telehealth and virtual consultations, to help manage bed capacity.
Though the virtual ICU concept is not a novel one, Oregon didn’t previously have any such program, Joe Ness, the Portland-based health system’s senior vice president and COO, said in a phone interview.
“We were able to accelerate our development and implementation of [the virtual ICU] because of the pandemic,” he said. “The ability to keep the patient closer to home if at all possible and utilize literally all of the ICU beds in the state to their fullest capabilities is really a huge advantage.”
As of Dec. 17, there have been 5,745 Covid-19-related hospitalizations in Oregon, of which, 1,125 received care in an ICU, according to state data. There are approximately 700 staffed adult ICU beds in the state.
OHSU has implemented the GE Healthcare Mural Virtual Care Solution, which combines EHRs, as well as audio/visual technology, displays and monitors so that a physician can provide remote care to ICU patients from miles away, Dr. Matthias Merkel, senior associate chief medical officer at OHSU, said in a phone interview.
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“For me as physician, it looks the same. It doesn’t really matter if I look at an ICU bed here in our academic center or if I [remotely] look at an ICU bed at one of our community partner hospitals,” he said. “It looks exactly the same — the vital signs, the ventilator data, the laboratory data. So, it makes it much easier to really use that and screen patients. And then there is artificial intelligence built in, which it pops up the most urgent cases.”
The health system is using the solution at its three adult hospitals to support its on-site ICU teams as beds fill up, Ness said.
In addition, via its existing on-demand telemedicine consulting services, the health system is providing critical care expertise to five community hospitals around the state. Eventually, virtual ICU programs will be set up in those hospitals as well.
Telehealth programs, like the virtual ICU, help keep patients in their communities and closer to home, which has been proven to improve care and reduce costs, Merkel said. Patients don’t have to travel long distances, and their loved ones don’t have to travel with them and manage various logistics, such as setting up living arrangements. Also, patients can continue to work with physicians who have their information and know their medical history.
“The consult service we are offering right now has certainly helped a lot of our community partners keep Covid-19 patients in their ICU, which they would not have been able [to do] without our support,” Merkel said.
The virtual ICU has been beneficial for clinicians as well, helping them save time and other scare resources, like personal protective equipment, he said.
“As a clinician having done both — treating Covid-19 patients in the physical ICU and [virtual ICU] — being able to just connect via a computer and not having to put on PPE, it really helps,” he added.
Photo credit: Oregon Health & Science University
