Patients being treated in the pediatric intensive care unit at MassGeneral Hospital for Children now have doctors virtually at their bedside 24/7 via a new home-to-hospital program.

MassGeneral Hospital for Children (MGHfC) and the Partners Center for Connected Health, both part of Partners HealthCare in Boston, teamed up to launched the new program.

Six pediatric intensive care unit (PICU) physicians from MGHfC now have videoconferencing units in their homes. When they are needed for a consultation they videoconference in from home to a portable telemedicine station positioned at the patient's bedside. The attending physician can then see the patient, talk with clinicians on-site, personally evaluate the child's condition and make treatment decisions. Special cameras and scopes can also be attached to the hospital-based unit to allow for closer evaluation of the patient.
 
No treatment delay
In one recent case, an 11-year-old girl was admitted to the PICU at 2 a.m., with respiratory distress. From home, the on-call attending physician was able to evaluate the patient on video, identify the respiratory problem and discuss treatment with the nurse, PICU fellow and respiratory therapist at the patient's bedside. The on-call attending physician was also able to address the mother's concerns and supervise the patient's treatment without having to take the time to travel back to the hospital from home.
 
"Since launching this program in May, we are already seeing that the Connected Pediatric Critical Care program is significantly improving the quality of care, team communication and staff responsiveness during evening hours and weekends when our attending physicians, ultimately responsible for patient care, have left the hospital," said Natan Noviski, MD, chief, Pediatric Critical Care Medicine at MGHfC. "Because the attending physician can remotely examine the patient and communicate with the on-site staff directly, decision making can be enhanced and the quality of care improved."
 
Overnight and weekends, on-call attending physicians were traditionally contacted via telephone by the covering fellow or resident in the PICU. The attending physician would provide guidance, via telephone, without input from the rest of the team and without personally seeing the patient. The attending would then decide if it was necessary to return to the hospital.
 
"Videoconferencing is not new, but the application of this technology – connecting at-home physicians with their patients and the hospital-based medical team – is a novel and important advance in critical care medicine," said Joseph C. Kvedar, MD, director, Center for Connected Health. "We anticipate that other intensive care units, for both adult and pediatric patients, could benefit as well."
 
The Connected Pediatric Critical Care program also creates a more robust teaching opportunity, allowing residents to be more involved in the team approach essential in an intensive care environment, he said. Also,  parents feel more confident in their child's care and more connected to the treating physician, giving parents the opportunity to interact directly with the attending doctor at home.