Charité project ERIC: Tele-visit for intensive care patients recommended for standard care

Innovation Committee endorses first projects

Tele-ICU-Visiten Roboter Copyright Wiebke Peitz Charité
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Berlin, 02.02.2022 – The ERIC* innovation fund project is one of the first to be recommended for nationwide coverage. This has now been decided by the Innovation Committee at the Federal Joint Committee (G-BA). The project under the consortium leadership of the Charité – Universitätsmedizin Berlin has shown that telemedicine can sustainably reduce the risk of long-term consequential damage for intensive care patients. The core of the successfully evaluated project is a central e-health platform for multi-professional networking and location-independent tele-visits.

In Germany, more than two million people receive intensive medical care every year, and about 20 percent of them have to be artificially ventilated. Numerous patients suffer from consequential damage with cognitive, functional and psychosocial restrictions or organ dysfunctions after treatment. The goal of the ERIC (Enhanced Recovery after Intensive Care) project launched in 2017 was to sustainably improve the quality of care and patient safety. Under the consortium leadership of Charité, the project partners from Ludwig-Maximilians-Universität Munich, Technische Universität Berlin, Fraunhofer FOKUS, Klinik Ernst von Bergmann Bad Belzig gGmbH and the health insurance company BARMER worked together in partnership. Together they were able to show that with the help of the multiprofessional telemedical visit, the risk of consequential damage for patients can be reduced. Via the central e-health platform, the communication and data collection of the 15 participating intensive care units were bundled in a telemedical centre at the Charité. A follow-up service was established with the region’s general practitioners to provide patients with the best possible support after intensive care therapy. The innovation committee of the Federal Joint Committee had funded the project with around 6.8 million euros from 2017 to 2020.

For intensive care patients, the best possible care is essential for survival. It is not only a question of whether, but also how patients survive the disease. ERIC was therefore designed to bring the latest scientific findings in the form of quality indicators directly to the patient’s bedside. “The daily telemedical ward rounds in the intensive care units were essential for this. This helped us to implement evidence-based knowledge in every participating facility and thus prevent long-term consequences for patients,” says Prof. Dr. Claudia Spies, project leader and director of the Clinic for Anaesthesiology with a focus on operative intensive care medicine at Charité. She adds: “The pandemic was a significant and successful test for our project. In this challenging and difficult-to-calculate situation, telemedicine contributed to a high quality of care across the board. We were able to generate comprehensive knowledge and make it available to everyone in the shortest possible time. ERIC also provided the basis for telemedical networking in the Senate’s SAVE-Berlin@Covid-19 concept. Overall, we all learned a great deal together and in professional cooperation.”

The ward round robot for the wards on site is equipped with several cameras and a microphone. Thus, during the tele-visit, the medical staff is connected in real time with specialists and nursing staff at the Charité. Together they assess the patient’s state of health on the basis of eight quality indicators – for example medication or nutrition – and discuss further therapy. “The ward round robot can move close to the patients with its camera. This enabled us to work out strategies together with the treatment team on site and provide advice and support if necessary,” explains Dr Björn Weiß, senior physician at the Department of Anaesthesiology with a focus on surgical intensive care medicine and coordinator of the project. This includes the use of the prone position, the adjustment of the ventilator or the dosage of medication. In addition, general practitioners, physiotherapists and rehabilitation centres were also involved via the platform. In the meantime, ERIC has been successfully evaluated and is recommended by the Innovation Committee for transfer to standard care. In the next step, the health ministries of the Länder are therefore asked to examine whether telemedical ward rounds should be established in intensive care units in their Länder.

*ERIC – Enhanced Recovery after Intensive Care

ERIC was funded by the Innovation Committee of the Joint Federal Committee (G-BA) under the consortium leadership of the Charité for 44 months with a total of around 6.8 million euros in the New Forms of Care module. The Ludwig Maximilian University of Munich, the Technical University of Berlin, Fraunhofer FOKUS, the Ernst von Bergmann Bad Belzig gGmbH Clinic and BARMER were involved as consortium partners. The primary goal was to improve the implementation of evidence-based quality indicators in order to avoid long-term consequences of intensive care treatment. This was achieved through inpatient and outpatient networking with the help of a data-secured e-health system as well as a competence-based qualification and staff development concept for the local and regional improvement of treatment quality. Fifteen intensive care units in Berlin-Brandenburg hospitals were involved. The last of the 1,500 patients was admitted to the project in March 2020. 800 of them were also followed up over a period of six months after discharge from the hospital.

Links:

Video zum Visitenroboter

Projektwebsite ERIC

Projektbeschreibung beim G-BA

Projektbeschreibung ERIC – Charité

PM zu Save – Sicherstellung der akuten, intensivmedizinischen Versorgung im Epidemiefall Covid-19