Instrumented Interconnecteds Intelligent

Dr. Timothy G. Buchman, MD, PhD, Founding Director, Emory Center for Critical Care, Woodruff Health Sciences Center, Emory University

Dr. Timothy G. Buchman, MD, PhD, Founding Director, Emory Center for Critical Care, Woodruff Health Sciences Center, Emory University

By Dr. Timothy G. Buchman, MD, PhD

Remember when airplane cockpits were filled with round gauges, each providing a piece of basic information to the pilot?

In most hospitals today, we essentially operate on that same old-fashioned model for critically ill patients – those in the Intensive Care Unit (ICU). Machines provide separate pieces of data about a patient, say, heart rate, blood pressure or organ function. It’s then up to the doctor to watch all of this data and make decisions.

Take for example my patient, lying in the ICU with tubes of various sizes snaking into her body. Her husband and children look on while she is tended by an experienced critical care nurse. Eight infusers drip powerful drugs into her veins. A microprocessor-controlled ventilator regulates the composition, volume and pressure of each breath she takes.

A catheter threaded from her neck deep within her heart and another buried in her wrist continuously display the pressures at various points in the bloodstream. Light transmitted through her earlobe reads out the concentration of oxygen in the capillaries.

Another light transmitted through the breathing tube reads out the concentration of carbon dioxide leaving her body. Electrical voltages dancing across her chest are displayed as two of the nine flowing waves.

The family stares, mesmerized by the raw data entering and exiting the screens.

“How is she doing?” they ask. “When will she be able to breathe on her own?”

“She’s doing ok,” I reply. “As for the breathing tube, maybe tomorrow.”

Until now, that was the best I had to offer. That was the best any of us who work in the ICU could offer. We’ve spent our professional lives looking at data without harvesting it, relying on personal experience without the benefit of objective analysis, retreating to best practices while hoping for a good outcome.

As a pilot and owner of a general aviation airplane, I’ve often wondered why the same advanced systems I rely on in the modern cockpit communicating with air-traffic control can’t also help us predict and avoid trouble in critical care medicine.

The fact is, they can. The technology exists today.

(Bill Adler/Feature Photo Service for IBM)

Dr. Timothy Buchman, MD, PhD, Founding Director, Emory Center for Critical Care, Woodruff Health Sciences Center, Emory University

A novel partnership between IBM and Excel Medical Electronics is changing the game. Excel Medical’s tools allow us to harvest and archive the “Big Data” that was previously lost. IBM InfoSphere Streams makes real-time analytics possible.At EmoryUniversityHospital, we’re piloting this streaming analytics system in the ICU to spot trends and correlations faster and more reliably than any health care professional could identify.Trends like respiratory failure, abnormal heart rhythms and serious infections. Finding problems early means correcting them more easily and more effectively. It’s the first step towards smarter care.

Smarter care is all about situation awareness. Perceiving data. Comprehending data. Projecting what will happen to our patient if we choose to stop drug A, or start drug B, or simply leave things as they are. Building a medical “GPS navigator.” We need high-tech so that we can get back to high-touch.

That would be smarter care. For – and by – a smarter planet.

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