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Technology Enabled Care for the 21st Century

The VISICU eICU® Program is powered by the eCareManager™ system and is engineered specifically for redesigned critical care in the 21st century - as called for by the Institute of Medicine in Crossing the Quality Chasm: A New Health System for the 21st Century. It is also designed methodologically to reduce the likelihood of error as outlined by Leape in his classic review paper, Error in Medicine, JAMA, 272:1851, 1994-

  • Reduced reliance on memory
  • Improved information access
  • Error proofing
  • Standardization
  • Training

The eICU functions like "air traffic control" and the eCareManager system like "cockpit sensors" that extend the expertise of specialist care (intensivists) to critically ill patients and minimize complications by reducing the time between problem identification and intervention. eCareManager data provides information about the quality of clinical practices and resource utilization and generates reports for focused performance improvement efforts. This eSolution and the resulting care delivery model provide more consistent and standardized care than traditional experiential and idiosyncratic medical practice.


A Call for Change

The Institute of Medicine (IOM) has been at the forefront of highlighting medical errors and quality of care problems, and calling for health system redesign. The VISICU eSolution is uniquely suited to answer this call by enabling the continuous review of patient information by the eICU staff and providing consistent clinical oversight that is remarkably absent from most of the health care system. This care model is consistent with the IOM's suggestion that transparency rather than secrecy is necessary in the 21st century health care system, (Crossing the Quality Chasm: A New Health System for the 21st Century).

Furthermore, the IOM noted six challenges of redesign imperatives in the health care system, that include:

  • Redesigned care processes
  • Effective use of information technologies
  • Knowledge and skills management
  • Development of effective teams
  • Coordination of care across patient conditions, services, and settings over time
  • Use of performance and outcome measurement for continuous quality improvement and accountability
The eCareManager system responds to the challenges put forth by the IOM and by enabling fundamental redesign of care delivery and incorporating the effective use of information technology. The Source evidence-based decision support system, Smart Alerts®; and the eCare Manager provide knowledge management. Skills management is accomplished by leveraging intensivist expertise across a broad network, and teams of caregivers are able to communicate seamlessly across patient situations and over time. Data are entered in digital form and stored in a relational database that allows for accurate and streamlined performance improvement and ultimate accountability.

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