The computer in the care of critically III patients

Computer technology and biomedical electronics have been successfully employed in the care of critically ill patients by many medical centers and hospitals. In some settings automation of physiological measurements and record keeping have relieved the nurses of time consuming tasks, which enables them to devote more of their time to direct care. Some intensive care systems assist in the clinical decision making as well as in performing warning functions. A few systems perform closed loop feedback control of certain physiological variables by means of computer controlled infusion pumps and rigidly structured algorithms. Evidence indicates that the additional cost of the computer may be recovered through enhanced personnel performance and more rapid patient stabilization which results in earlier transfer from intensive care to a semiprivate room. However, irrefutable proof that the systems are cost effective is still lacking mainly because of the difficulty in quantitating the economic value of benefits. The applicability of this technology depends largely on the nature of the clinical environment. Well-organized units wherein the patient management is highly structured provide the maximum opportunity for efficacious and economic use of computer-based intensive care system. Analysis of the activities and procedures of the unit must precede system design and implementation to appraise the appropriateness, to identify the clinical requirements, and to avoid improper application of the technology.