Abstract

Advances in networking and remote monitoring capabilities have already begun to redefine the physical and organisational boundaries of the intensive-care unit (ICU). Although commonly thought of as a self-contained unit, the ICU draws on informatics resources located outside the physical space of the unit.

Purpose
The main objective of deploying advanced informatics in the modern ICU is to electronically integrate the patient and all aspects of patient care with hospital and ICU informatics systems. The second goal is to transform all patient-related data into actionable information using smart technologies. This session will explore both the operational and design requirements needed to ensure this connectivity.

Methods
New technologies are changing the interface of care collaboration and patient monitoring, requiring ICU design strategies that can incorporate them. These issues will be explored through the perspectives and experiences of an intensivist in critical-care medicine and a healthcare architect trained in internal medicine. Accounts of advanced informatics in the critical-care environment will be discussed via case studies, design guidelines and project examples.

Results
Smart ICU infrastructure necessitates a connectivity envelope that encompasses the patient, medical devices, healthcare staff, and pharmacologic and other care elements. This requires integration of bedside wired and wireless infrastructure, connectivity hardware in the patient room, medical devices to transmit their data, and placement of middleware (software that connects medical devices with the hospital’s operating systems) on hospital and ICU networks.

Real-time locating solutions can improve management and workflow by tracking tagged assets, monitoring device usage, and controlling product inventory. Devices can be monitored by middleware, thereby supporting web-based device viewing, alarm transmission and remote troubleshooting. New informatics systems can transform data into actionable information, highlight the most important patient alarms, and enhance infection control and patient room management.

Conclusions and implications
The future ICU will require a robust life-support system capable of organising information and creating a connectivity envelope around the patient, which interfaces with the ICU and hospital networks. A deep understanding of advanced informatics and use of new technologies in the practice of critical care are vital to the future of ICU design.