“I live and die by waveforms and not just a snippet. I need to see the entire waveform and what led to an event to determine an intervention or root cause.” The intensive care specialist told me this with desperation in his voice. He’s the one who has to tell families that their loved one is gravely ill, that another cardiac event could happen at any time, without warning, or that their loved one has expired. I could understand the desperation. With over 25 years of experience as a critical care, ICU, and flight nurse, and now a clinical consultant, I have personally experienced these challenges and work with physicians and members of the health care team every day with a front-row seat to their challenges, their wins, and their losses. I see their dedication and selflessness. I see how hard they battle against disease, fatigue, or expectation. And I can say with confidence that they are some of the hardest-working, most talented individuals that walk this Earth. But without the tools they so desperately need to win these battles, they suffer needlessly. It’s time we all recognized it: “Health care, we have a problem.” I propose that by giving physicians and all members of the care team the data they need to practice medicine the way they want to, we can solve more problems than even imaginable. Give them the data Most physicians only have the benefit of limited visibility of data, leaving them without all of the data they need to make life-saving decisions. This is especially true in critical care where the devices hooked to a patient to monitor them – cardiac monitors, ventilators, infrared scanners, and more – can produce up to 800,000 data points per hour, per patient. Within this data lies the most telling information about a patient’s condition, including waveforms and important trends signifying potential events that can mean the difference between life and death. Doctors, nurses, and others need this data, both in real-time data, as patients are producing it, and retrospectively, from that patient’s entire length of stay. But all too often, this data is locked down inside the bedside device, only available at the point of care with little to no storage to enable remote access, let alone integration with other patient information such as labs, meds, and imaging. Why is that so important? When seconds matter and life-saving decisions need to be made, physicians need access to all data, beat-to-beat, to get a deeper understanding of a patient’s condition and empower them to make data-driven decisions about treatment protocols. Amplified by the pandemic COVID has made these issues more apparent, but it has also brought more opportunities with it. While it is wreaking havoc on the world, leaving death and destruction in its wake, the massive amount of information created every day could be studied right now to save current and future lives–if that data was stored and accessible. Medicine should be able to retrospectively look at the condition, disease progression, and treatment of individual patients, and compare that data to other patient populations by using today’s advanced AI and ML tools to create patient trajectory monitors, deterioration scores and more. But when the data isn’t stored, the opportunity is missed. Let’s take COVID patients in critical care who are emitting a wealth of information through ventilator data alone. Since ventilators are not networked, their data isn’t stored. This means most ICU teams can’t access the data in real-time to support remote care and protect them from exposure, much less look at the data retrospectively to determine trends, expedite intervention, extubate faster, and create risk scores and analytics for future waves. Giving physicians and other members of the care team access to all of this data remotely can not only help keep health care workers safe, but can also expand staff capacity by giving providers who are in quarantine, coming out of retirement, or in another state can access to the patient data remotely to further improve patient care and decrease risk. Long-term storage of that data with easily accessible visualization tools also gives clinicians and data scientists the intelligence they need to best help that patient, predict respiratory deterioration, and ultimately have an objective, data-driven learning they can apply to other patients suffering now and in the future from the effects of the virus. And this is just one disease. As health care implements software-based monitoring technology that allows physicians and other members of the care team to truly access and analyze the information from real patients, more information can be harnessed about all disease processes. Create a new standard of care Health care has more data and technology than we have ever had before. It also has staff shortages, burnout, and an increasingly complex and aging population. We are still sending care teams into battle every day without the information they need to make decisions–and wondering why they suffer from burnout? Tech-driven solutions like virtual ICUs, remote monitoring, and telehealth will be critical to saving more lives and advancing care in this increasingly complex landscape. These “virtual” capabilities actually mean real opportunities. The unifying, storing, and visualizing of data is key to achieving this vision. Patient-centered AI at scale is built on data and allows the application of scientific clinical knowledge that will help health care as a whole get ahead of deterioration, and save more lives. It will also move health care into the new age while taking clinicians back to the reason they went into medicine in the first place: To save lives. How do we solve health care problems? It all starts with the data. Doctors, nurses, and all members of the health care team are exceedingly good at treating people who are sick. Let them treat health care with a healthy dose of the tools they need to do their jobs at the level they know they can. Doing so will change the face of health care as we know it–for all waves of this pandemic, and whatever else is yet to come. Pamela Miles is a nurse and health care consultant. Source
