As you might guess from the prior entry, somebody I know recently had an ICU visit. The hospital had to cut back staff, laying off nurses' aides and hiring some extra nurses, then making them do the former work of the nurses aides (changing sheets etc) because of regulations forcing them to have a higher ratio of patients to nurses. So, more nurses per patient but the nurses end up doing less actual nursing per patient because they are doing the work the aides did. Clever, no?

Anyway, to add fuel to the offshore outsourcing debate, I wondered how practical it would be to outsource patient watching. A trained nurse in a lower-income area, possibly on the other side of the world, would watch a patient via a live video feed and data feeds of all the instruments. If they see a problem, they would send an alert to a physically present nurse or doctor. They could see and talk to the patient, if the patient is responsive.

Since the bandwidth would be expensive for this, I imagine a lower-res video for real-time, though still good enough to see important things with remote pan and zoom control. However, on-demand they could jump up the bandwidth during an event. They would also be able to send a command to replay something they saw in full-resolution, with some delay.

To do this the local recorder would record the full resolution video, even HDTV, and keep it for an hour on a hard disk. It woudl transmit a lower-res version live. Since most hospital beds are static scenes this would compress well. Motion, instead of causing artifacts would just call for more bandwidth from the total pool. However, when the watcher says, "let me see the last 10 seconds" the patient's recorder would re-transmit it in full HDTV if necessary.

But the main point is the overseas workers might be so cost effective that you can have near full-time monitoring of a patient by a skilled professional. In many hospitals and nursing homes, the staff might visit only once every few hours, perhaps every 15 minutes at best. You can die in 15 minutes.

Of course it's spooky from a privacy standpoint to be watched all the time, this would not be for everybody. And better instrumentation that's non-intrusive and can detect emergency events quickly would be even better. Though nothing will do as well as a trained person right now. This might also allow more effective home care, though of course in that case it might be too long before an ambulence arrives if an emergency is seen on the monitor. And you had better hope your internet connection does not go down.

Still, there's a lot to say for home care, considering just how many people die or suffer greatly due to hospital-caught infections. As I noted earlier, they are the 4th leading cause of death.