2024-02-13 12:52:58
If there is a trait that has characterized Medicine throughout history, it is its power to transform society and, at the same time, adapt to the changes and improvements that occur in it. Thus, it is not surprising that Let us actively participate in the technological revolution that we are experiencing at the moment, translated into the start of artificial intelligence, big data and what is commonly called ‘Internet of things’ (automatic data exchange between devices and servers).
The Intensive Medicine specialty is not immune to this situation. Artificial intelligence algorithms are beginning to be created with analysis and automatic learning, the so-called machine learning, applied to protocols of various kinds that improve the care of critically ill patients and allow us to anticipate severity. At the same time, emerging clinical and care simulation tools that integrate smart glasses are beginning to be developed; or sensorization systems are proposed through the use of new smart devices, to name just a few examples. However, we would be reckless if we let these different developments allow us to have the feeling that we intensivists have already come a long way on the path of artificial intelligence and that it is a fact in our units. On the contrary. The automation of tasks continues to be a challenge in Intensive Care, and there is still much to implement regarding the management and use of large databases.
The development and implementation of this technological revolution must go in parallel and in line with a clear digitalization of services, and especially telemedicine.. If there is something that we confirmed during the last pandemic in Intensive Medicine, it is everything we might contribute remotely. Intensivists have always defended that our work takes place beyond the four walls of an ICU, and this is true both in person and virtually.
The benefit that the use of different devices had for patients and families to allow contact and communication between them when visiting the units was not possible has been clearly demonstrated. The effectiveness of the commitment to information exchange and coordination systems between Intensive Medicine services of hospitals at different levels for making decisions related to care, clinic or transfer is also a fact. But neither humanization programs nor planning, management and organization programs are understood if there is no adequate technological framework.
There is no real objective in our specialty that does not start from this digital implementation, whether it is the implementation of consultations and programs for the treatment of Post-ICU Syndrome or the adaptation and integration into national and international networks of patient records, each time more specialized. But if there is one field in which this urgent need stands out, it is in training and learning, both remotely and in advanced simulation.
“Task automation continues to be a challenge in Intensive Care and there is still much to implement regarding the management and use of large databases”
The models for the acquisition of skills, such as those proposed by Intensive Medicine in organ donation and transplantation for resident doctors, are not conceived without e-learning. Also training in a priori exclusively face-to-face areas such as immediate life support for critical cardiological patients or ultrasound skills adapted to intensive care, to continue citing just a few examples.
We still do not know where the ceiling of e-learning is, but we do know that it should not be limited only to the personnel of our services or to future promotions of doctors. We know this well from the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC). And it has been precisely this tool that has allowed us to strengthen part of our development cooperation programs.
Thanks to the voluntary work of many intensivists in our country, we have been able to create ad hoc training programs for colleagues in hospital services in developing countries or countries at continuous risk of a health emergency. For example, in the hospitals in Rwanda where the SEMICYUC’s UCI Sin Fronteras international cooperation solidarity program has established Intensive Medicine services, the lessons taught by Spanish intensivists in the field are complemented with remote virtual classes, allowing the same time that contact is more frequent and learning is continuous.
Also within UCI Without Borders, the training programs developed by SEMICYUC specialists regarding the prevention of infections related to healthcare have been transferred to other countries. The Zero Projects, a name that encompasses the different programs (Zero Bacteremia, Zero Resistance, Zero UTI, Zero Pneumonia) and which in our country are carried out with the Spanish Society of Intensive Nursing and Coronary Units (SEEIUC) and the sponsorship of the Ministry of Health, are an asset of incalculable value and we are now in a position to export them thanks to e-learning. Bolivia has been the first country in which we have been able to do so and I have no doubt that, like the ONT, it will be a Spanish model of international reference.
Intensive Medicine embraces the technological revolution without losing sight of the humanization of the patient and their safety when they enter our services, nor the well-being of professionals to create environments of better quality of care, nor our energizing power. An advance perhaps not huge, but in the best of directionss. The path is well marked
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