ICU of the Future- Egyptian Critical Care Summit 2015
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ICU of the Future lecture presented by Dr Lluis Blanch at the Egyptian Critical Care Summit 2015. Egyptian Critical care Summit is the leading medical event and exhibition in Egypt
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ICU of the Future- Egyptian Critical Care Summit 2015
- 1. Dr. Lluís Blanch Senior Critical Care Director of Research and Innovation Corporació Sanitària Parc Taulí Cairo, 13th of January 2015 ICU of the Future D r.Lluís Blanch
- 2. L.Blanch is inventor of one Corporació Sanitaria Parc Taulí owned US patent: “Method and system for managed related patient parameters provided by a monitoring device,” US Patent No. 12/538,940. L.Blanch owns 10% of BetterCare S.L. which is a research and development company, spin off of Corporació Sanitària Parc Taulí. Financial Disclosures Lluis Blanch MD, PhDD r.Lluís Blanch
- 5. ICU design: coordinated with other hospital units and transport systems. Halper NA Chest 2014;145:399 D r.Lluís Blanch
- 6. The connectivity envelope includes hardware for source tracking and data acquisition Halper NA. Chest 2014;145:903 D r.Lluís Blanch
- 7. Advanced ICU Informatics: Association Patients ID or patient location Interoperability Data generated by one device can be accessed and used by another Time Synchronization Vital for maintaining an electronic flow sheet and tracking alarms and responses Medical Devices are Informatics Platforms Integration with ICU middleware D r.Lluís Blanch
- 8. Advanced ICU Informatics: ICU Middleware Alarm systems Device servers Smart displays Telemedicine D r.Lluís Blanch
- 10. PICIS Critical Care Manager D r.Lluís Blanch
- 12. IntelliSpace Critical Care and Anesthesia ICIP Philips D r.Lluís Blanch
- 13. INNOVIAN de Draeger INNOVIAN Dräger D r.Lluís Blanch
- 15. J Clin Monit Comput DOI 10.1007/s10877-014-9592-4 1397 patients. From 2006 to 2008 D r.Lluís Blanch
- 16. ICU Computerized Information systems: Advantages: -electronic chart -import data of different devices -nursing notes and events -scores -superior alerts and alarms Limitations: -too much data, indicators -safety: adverse events control -data warehouse exploitation -not integrated with HIS D r.Lluís Blanch
- 17. Information overload ICU ITs Lack of Information ! D r.Lluís Blanch
- 18. PLOS ONE 2014;vol 9,e107930 Normal and abnormal Laboratory Values displayed by both Interfaces subclassified according to Gold Standard Judgment: “clinicians marked the values about which they would like to be alerted” D r.Lluís Blanch
- 19. Crit Care Med 2011; 39:34 –39 Potentially injurious ventilator settings for 1 h during the first 3 d of MV D r.Lluís Blanch
- 20. Crit Care Med 2011; 39:34 –39 ► ► ► D r.Lluís Blanch
- 21. JAMA Published online March 3, 2014 An alarm is efective when: 1. Activates when a serious problems develops 2. A clinician recognizes the alarm as being indicative of said problem 3. The necessary know-how to address the problem at hand exists D r.Lluís Blanch
- 22. Lilly C et al. Crit Care Med. 2014 Nov;42(11):2429-36 ICU telemedicine programs: • lower ICU (0.79; 95% CI, 0.65–0.96) and hospital mortality (0.83; 95% CI, 0.73–0.94) • shorter ICU (–0.62 d; 95% CI, –1.21 to –0.04 d) and hospital (–1.26 d; 95% CI, –2.49 to –0.03 d) length of stay. Claims Costs D r.Lluís Blanch
- 24. CCM 2013; 41:1502–1510 Physicians use a limited number of clinical information concepts at the time of patient admission to the ICU. The electronic medical record contains an abundance of unused data. Information Overload in ICU Reported frequency of utilization of data elements in EMR HR SpO2 RR MAP D r.Lluís Blanch
- 25. Patient & Waveforms & Intelligence D r.Lluís Blanch
- 28. Hours Discomfort Dyspnea - Air Hunger - Work/Effort - Tightness Agitation Risk of Extubation Asynchrony Report ? D r.Lluís Blanch
- 29. Patient Safety & Quality Healthcare. January/February 2010 D r.Lluís Blanch
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- 32. Real World Data Differences with RCTs Type Results Population Monitoring Randomization Cost Observational Effectivity No restrictions Not Necessary No Cheap D r.Lluís Blanch
- 33. Data-driven learning system Celi LA et al. Am J Respir Crit Care Med 2013;187.1157-60 4Vs: value, volume, variety, velocity D r.Lluís Blanch
- 34. AJRCCM Articles in Press. Published on 28-July-2014 Obtaining information from various sources, often with difficulty D r.Lluís Blanch
- 35. Old Organization + New Technology = Costly Old Organization D r.Lluís Blanch
- 36. Toll E. JAMA, June 20, 2012 physician artist family When the physician saw the drawing, wrote: “The economic stimulus bill has directed $20 billion to health care information technology, largely funding electronic medical record incentives. I wonder how much this technology will really cost?” The EMR should improve efficiency so that we have more and not less time to communicate with our patients D r.Lluís Blanch
- 37. Thank you ! lblanch@tauli.cat D r.Lluís Blanch