The last few years has witnessed a phenomenal implosion in the field of critical car computing. We are in the age of the microchip. A secretary can spell a document in a few seconds. A ward clerk can produce a graph of a patient’s serum sodium, value during the last five admissions, with a few key strokes. We take it for granted that a microchip will analyze a 100,000 heart beats every day and identify arrhythmias and asystoles. No longer are we impressed by microchips in pumps, ventilators and pulse oxymeters. Computer generated EEG reports are common place.
In a Critical Care Unit large volumes of data must be stored, processed and used for quick and repeated clinical decision making. Effective communication is vital in CCU. Networking with different departments ensures availability of lab data on a real time basis.
Indecipherable handwriting will be a thing of the past. Using a modem and a PC the neurosurgeon can make effective rounds from his bedroom. In a difficult case, instantaneous clarification can be obtained from a specialist in another continent, transmitting all the data. Computer systems normally wait till a request is made. If requested, the therapeutic aspects of various antibiotics – the specific bacteria it covers, relative effectiveness, complications cost etc will all be displayed. Yet it cannot countermand an order for a drug that is totally inappropriate or even dangerous. Tomorrows computer with artificial intelligence in the form of neural networking, will be programmed to respond in different ways. A nurse in the Critical Care Unit (CCU) will require a computer generated order before the physicians order is implemented. The computer will take into account every known parameter, for the given patient while evaluating the physicians orders. A warning message will come on the screen – “Please check dose again” and the reasons will be displayed including the relevant citations. Systems which intercept orders BEFORE they can be executed are now available in several centers. For example, an investigation which is not standard, for the work up of a particular condition will not be transmitted to the radiology department. An extensively used program called HELP (Health Evaluation through Logical Processing) has been proved to be effective not only in making a diagnosis, but also in alerting the physical to avoidable problems. Treatment suggestions are also given. An integrated “Medical Information Bus” is on the anvil. Linked to 255 devices, this network will intercommunicate in 73 seconds.
