One in five Americans live in a rural community served by rural hospitals yet only 1% of ICU resources areavailable to these hospitals. When the level of care required by a patient exceeds the capabilities of theadmitting hospital, the patient is transferred to a better-equipped tertiary hospital. Approximately 800,000patients require mechanical ventilation every year in the United States (pre-COVID). Treating mechanicallyventilated patients not only requires specialized equipment, but also specialized skills as well which are difficultto find in rural settings. Our group proposes novel research to demonstrate the power of telemedicine in therural setting by extending the reach of pulmonary critical care specialists. By enabling pulmonary critical carespecialists at distant sites, rural hospitals can treat more patients without transferring them. Data suggestspatients who are transferred from rural hospitals to tertiary care centers suffer delays in care, adverse events,and higher mortality. Unfortunately, due to high transfer rates, significant amounts of revenue are lost andoperating budgets at rural hospitals are generally inadequate to support replacement and integration ofcutting-edge ventilators to gain telemedicine capabilities. Our research and development is focused onpreparing a solution which can extend the geographic reach and enhanced remote capabilities of pulmonarycare specialists who are typically located in urban and suburban settings to those rural institutions while at thesame time protecting the hospital's legacy investment in ventilator equipment. To achieve these goals, we havedeveloped an in-line respiratory circuit sensor (TeleLine) prototype that we will further refine forcommercialization and eventual in-field deployment. The TeleLine is a non-invasive sensing suite to anyexisting ventilators and equipping them with both data logging and remote monitoring capability. The patient'srespiratory response to mechanical ventilation can be captured locally and securely transmitted to a remotesite with appropriate expertise in pulmonary critical care. We will further develop the TeleLine in two aims: Aim1) to refine the existing TeleLine prototype for plug-and-play, vendor-agnostic ventilator interfacing, andventilator data logging; and Aim 2) to develop and benchmark supporting data collection and machine learninginfrastructure for facilitating remote patient care. Successful completion of this project will enable a Phase IIprogram that enhances device manufacturability, clears critical benchmarking for initial device regulatoryapproval, and further develops machine-learning assistance capabilities of the TeleLine system.
Public Health Relevance Statement: Project Narrative
Rural hospitals serve nearly 20% of the United States population with only 1% of Intensive Care Unit (ICU)
resources contributing to worse outcomes for critically ill, rural patients. While telemedicine can improve ICU
outcomes, tele-critical care providers as of yet lack real-time physiologic ventilator data. In this grant
application, we propose the further development of the TeleLine, a connected plug and play ventilator circuit
monitor device, through two aims: Aim 1) to refine the existing TeleLine prototype for plug-and-play,
vendor-agnostic ventilator interfacing, and ventilator data logging; and Aim 2) to develop and benchmark
supporting data collection and machine learning infrastructure for facilitating remote patient care.
Project Terms:
