When I first read this article, it was on New York Times Paid section, by Philips. After some digging around, this idea of eICU appeared to be not bad at all, both in theory and in practice. Doctors and nurses, especially those taking night shifts, are usually exhausted when taking care of patients on the whole floor. The eICU unit at Emory Critical Care Center introduced an additional layer to regular ICU care, especially at nights, by putting all the patients together (virtually) and getting them monitored by caregivers in Perth, Australia. eICU is not a substitute for traditional ICU night-shift physicians and nurses, but a way to help them in providing more reliable healthcare, by relieving them from burnouts. This whole process is moderated by a specialized data analysis team, who are responsible for providing accurate information and live updates of the patients. In a 15-month review between April 2014 to June 2015, this system covering 136 beds at five hospital sites showed an estimated $4.6 million decrease - a $1,486 reduction in average Medicare spending per patient, and a decrease of 2.1% of 60-day inpatient readmission rate.

Potential Issues I see here…

(1) Better information system:

In general, it is easier to monitor 10 patients than monitoring 100 patients at the same time, especially in the settings of ICU where information flow is tense. Better information system could help caregivers focus on the most important issues right now, by prioritizing information to be shown, or giving reasons for prediction and suggestions to help caregivers better understand the situation. 

(2) Medical training in different countries:

In the eICU example at Emory, the other team of caregivers are from Australia. In general, this idea of bringing caregivers in another country would have the potential issue of background and medical training from different systems. How to unify knowledge (and experiences) of both physicians on the other side of the monitor and physicians on site is something to consider.

(3) Responsibility of caregivers on the other side:

Legal issues will definitely arise when multi-country telehealth system is in practice: what kind of responsibility the caregivers from another country are taking, what liabilities they are holding, what penalties they will encounter if something is wrong, whether they are just “advisors” instead of persons who can also take actions. This is particularly important here where even our physicians and nurses are usually in deep trouble of medical accidents, not to mention bringing in physicians from another country.