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INTERNET SIMPLIFIES FAMILY COMMUNICATIONS IN THE ICU

(DES PLAINES, Ill., September 8, 2004) - Referring physicians and families found Internet-based communications helpful during a child's stay in the pediatric intensive care unit (PICU), according to a study published in the September issue of Pediatric Critical Care Medicine.

Individualized, password-protected websites were created for the PICU patients in the study. Families could check the child's clinical status, read the nurses' notes, and view patient images on the website. The family websites also had a messaging area where nurses and family members can exchange comments and questions. Referring physicians had a separate website for each child where physician notes and radiological images were available.

"We found that individualized patient web pages worked and were even better than we had expected them to be," says Dana A. V. Braner, M.D., professor of pediatrics and chief of the division of critical care at Doernbecher Children's Hospital, Oregon Health and Sciences University in Portland. "The web gave us an easy-to-implement communications tool that can be used to communicate with both the families of our patients and referring physicians."

One of the challenges of the intensive care setting is accurate and timely communication of patient medical status. Family members of a critically ill children and referring physicians often want more information than ICUs are able to provide on an on-going basis. To complicate matters further, most children's hospitals serve a large geographic area.

In 1999, the PICU at Doernbecher Children's Hospital in Portland, OR, established the first web-based link for PICU patients, allowing their families and referring physicians to access regularly updated medical status information.

The researchers studied 78 patients and families enrolled in a PICU web-based communications program to describe the experience of the patient families and referring physicians.

The parents and families liked the system. Most (77%) of the surveyed family members and friends thought that the web page helped them share information. They found it easy to use and felt that it gave them more time to spend with their critically ill infant or child, since they no longer had to be the sole messenger of updates on the child's health.

The physicians responding to the survey said the system was easy to access, met their expectations, and enhanced their ability to care for their patients. "This makes me feel like I am there taking care of this child with you," commented one of the referring physicians.

Most (73%) of the physicians thought the web-based communications were easier to utilize than methods presently used to convey patient information, and many (62%) said that the web-based communication met their expectations. An unexpected finding was that referring physicians would prefer to refer patients to a hospital that offered this type of web-based patient information.

"The web offered referring physicians the opportunity to check on their patients at their convenience from any place, day or night," Dr. Braner says. "It also offered a secondary opportunity to provide more poignant information than is possible with a telephone. It is one thing to describe an x-ray and another thing to view the x-ray."

"Families still tell me how important the study was to them even though it's been over for more than a year," says Dr. Braner. "I think web-based communication will only improve from here and will serve as the hub for patient information in the future."

"There may be few things more important that we can do to enlist our patients and their families as partners in health care than to give them a voice, a sense of control, for it is the loss of control that patients of all ages describe as one of the most demoralizing aspects of hospitalization," says Barry P. Markovitz, MD, MPH, associate professor of anesthesiology and pediatrics at Washington University School of Medicine and St. Louis Children's Hospital, in an accompanying editorial. "Dr. Braner and his colleagues have shown us one demonstration of such empowering technology. Let us see where this path takes us."

"In light of how we use the web for everything, it is amazing that it has taken so long to see this application," said PCCM editor Patrick M. Kochanek, M.D., FCCM. "The Portland group has developed a formidable Internet communications model for other ICUs that need not be limited to PICUs. I hope in the near future this will become the global standard."

Published by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, Pediatric Critical Care Medicine is the first peer-reviewed scientific journal to focus exclusively on pediatric and neonatal critical care medicine. The bimonthly journal's regular content includes clinical papers, scientific investigations, and solicited reviews. Selected abstracts from articles in each issue are published in Chinese, French, Italian, Japanese, and Spanish. Additionally, selected abstracts from relevant scientific meetings appear in the journal

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For more information, contact Thomas Joseph, MPS, CAE at (847) 827-7282 or tjoseph@sccm.org.

The Society of Critical Care Medicine is the leading professional organization dedicated to ensuring excellence and consistency in the practice of critical care medicine. With more than 11,000 members worldwide, the Society is the only professional organization devoted exclusively to the advancement of multiprofessional intensive care through excellence in patient care, professional education, public education, research and advocacy. Members of the Society include intensivists, critical care nurses, critical care pharmacists, clinical pharmacologists, respiratory care practitioners and other professionals with an interest in critical care, which may include physician assistants, social workers, dieticians, and members of the clergy.