A conceptual framework for the ICU of the future evaluated by the MIMIC-III digital archive

Abstract

Purpose This study aims to analyze a conspicuous corpus of literature related to the field of technology-based intensive care research and to develop an architecture model of the future smart intensive care unit (ICU). Design/methodology/approach Papers related to the topics of electronic health record (EHR), big data, data flow and clinical decision support in ICUs were investigated. These concepts have been analyzed in combination with secondary use of data, prediction models, data standardization and interoperability challenges. Based on the findings, an architecture model evaluated using MIMIC III is proposed. Findings Research identified issues regarding implementation of systems, data sources, interoperability, management of big data and free text produced in ICUs and lack of accuracy of prediction models. ICU should be treated as part of a greater system, able to intercommunicate with other entities. Research limitations/implications The research examines the current needs of ICUs in interoperability and data management. As environment changes dynamically, continuous assessment and evaluation of the model with other ICU databases is required. Originality/value The proposed model improves ICUs interoperability in national health system, ICU staff intercommunication, remote access and decision support. Its modular approach ensures that ICUs can have their own particularities and specialisms while ICU functions provide ongoing expertise and training to upgrade its staff.