A tele-ICU is a remote command centre from which doctors and nurses watch the patients of several intensive care units at once, through the same device data and video cameras. It is also called a remote ICU or an eICU.
The idea answers a shortage. Patients in an intensive care unit (ICU) are best looked after by an intensivist, a doctor trained specially in intensive care. India has far fewer intensivists than ICU beds, and most of them work in large cities. A hospital in a smaller town may have a well-equipped ICU but no intensivist at night. The doctor on duty there may be a junior doctor who also covers several wards.
In a tele-ICU, each bed has a camera with a microphone and a speaker. The bedside machines are already connected through ICU device integration. So the command centre sees the same vital signs as the bedside team, every minute. The software sorts all the patients by how unwell they are, so that the most urgent case appears first on the screen. Deciding who needs attention first is called triage. The remote team then talks with the bedside team over video, and writes its advice into the patient's record. The bedside doctor and nurses still treat the patient. The remote team advises them.
Take, for example, a command centre in Bengaluru that watches 80 ICU beds in 10 hospitals in smaller towns across Karnataka. At 1 a.m., one intensivist and three nurses are on duty there. The software moves a 65-year-old woman in a 12-bed ICU in Kalaburagi to the top of the list. Her oxygen level has fallen from 95% to 88% in 30 minutes. The intensivist turns on the camera at her bed, watches her breathing and looks at her latest chest X-ray in the record. Then she calls the duty doctor at the bedside over video and advises a change to the ventilator settings. Twenty minutes later, the oxygen level is back at 94%. The intensivist moves on to the next patient on the list.
A tele-ICU also has routine work. The remote team does a video round of every patient twice a day. It checks that each patient receives the standard care, such as medicine to prevent blood clots, and it reviews the results that arrived overnight. When a heart rhythm looks abnormal, it may ask for a remote ECG interpretation.
A tele-ICU differs from a telemedicine app. In a telemedicine app, one doctor sees one patient over a video call, for a short consultation. In a tele-ICU, a team watches many very sick patients all the time, with live readings from their machines.