If you enter the intensive care unit (ICU) of a hospital any time soon, you may not want to know that most adults admitted to ICUs are not managed by a critical care team. The shortage of team members, or "intensivists" as Todd Dorman calls them, is setting off an alarm in health care that needs a response stat. Dorman, an M.D. and director of the adult critical care medicine division at Johns Hopkins Medical Institutions, points out that there are currently fewer than 10,000 intensivists in the U.S., but 35,000 to 40,000 are needed for sufficiently staffing the nation's ICUs. Dorman authored a paper suggesting that telemedicine may provide a way of stretching the expertise of existing intensivists in the future. He conducted a telemedicine study using cameras and data transmission equipment that showed that, with proper monitoring, death rates dropped 68% and complications dropped 50%. The lack of medical personnel and the potential cost savings associated with remote monitoring sends a message to medical equipment designers that their products will need to be Internet-ready in coming years, according to Dorman. "Better compression technology is needed so that bigger files can be transferred more quickly without just increasing bandwidth," he says. "Better transfer protocols are needed so that once 20 to 25% of a given bandwidth is utilized there should not be degradation of performance." For more information, visit www.med.jhu.edu.
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