We are an informal group with an important mission. Our mission is to accelerate the development of a “connected environment” in neurocritical care and realize the proposed benefits. These include tools for precision medicine and decision support, patient safety, cost reductions, and cost-efficient clinical trials.
The Working Group will build upon past efforts including funded projects from NIH and the Department of Defense, IMEDS (Draper Labs), the Integrated Clinical Environment (ICE from MDPnP), and recommendations from the recent consensus conference on multimodality monitoring (Neurocritical Care Society). The emphasis of this Group will be to facilitate the remaining work necessary to translate this prior work into clinical practice such that it benefits patients in neurocritical care. We realize that a company, an individual, a university, or the government cannot solve these issues alone but our collective expertise probably can.
How We Work
The illustration describes how we initially plan to work. We will start with a diagram for an ideal neuro ICU in terms of informatics (data flow, data sharing, informatics applications, etc.). Focus areas will be identified that are barriers to, or difficulties for, the creation of our ideal neuro ICU. The Focus Areas menu lists those that have been identified. We will collect background reference material and then each focus area will be discussed in our Forums (click on the Forums tab). The Forums will be used to develop Recommendations and other documents that will provide guidance to clinicians, industry, funding agencies, and government authorities. A goal is to get the Recommendations endorsed by one or more professional societies. The Forums will also produce ideas for fundable research projects or demonstrations that validate a function of the ICU architecture. At all times, our ICU informatics architecture will be updated based on the discussions and research projects. This process, itself, is subject to discussion and revision.
Why Neurocritical Care?
Neurocritical care is still in its infancy in terms of informatics and it is well behind other medical specialties. The data collected from each patient still varies from hospital to hospital and is rarely collected in a standardized format. Powerful informatics tools (visualization, decision support, etc.) have been shown to provide value but are only used in institutions that have developed their own unique data infrastructure. Unfortunately, these tools are rarely scalable or adaptable for routine care. Publications over the past decade point out both the need and the barriers but have done little to bring the technology into daily practice.
In the near future of neurocritical care, we will see the development of treatment methodologies that require a more robust informatics infrastructure. These include the use of imaging, genomics and biomarkers; the results of trials that will provide a more detailed stratification of traumatic brain injured patients; the development of meaningful analytics, visualization, and decision support techniques, and the adoption of consensus guidelines. The informatics requirements of the neuro ICU need to be determined now so they can be developed and deployed in time to use this new technology…in a Smart Neuro ICU.
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