Greater Accuracy and Efficiency of Care in Critical Patients in the ICU in the First Phase of the ehCOS SmartICU Pilot Run

Jul. 29, 2016

  • The integration of bio-signals from patient monitoring and life support has put an end to the loss of information in critical care units and reduce the time spent on data mechanization by more than 10%.
  • The data from monitored interoperate with the Electronic Health Record, allowing the healthcare professional to make more accurate decisions.
  • Data scientists are working in close relationship with physicians and nurses in order to develop high accuracy predictive models for the most critical situations in the ICU.
  • In the upcoming months the predictive models will continue to be fine-tuned, as well as the artificial intelligence algorithms that will manage alerts and suggest the best clinical, diagnostic or therapeutic decisions to physicians.

Madrid, July 29th, 2016 - everis and NTT DATA have announced the successful completion of the first phase of the ehCOS SmartICU pilot run in several intensive care units (ICUs) of the Virgen del Rocio University Hospital in Seville.

In the first three months of the pilot test, this technology has been used in the care of 147 critical patients from three intensive care units.

Medical device connectivity and interoperability benefit patient safety

Although we are immersed in the era of digital transformation and intensive use of healthcare information technologies, the data management systems have changed very little in recent years in the critical care units. At present, the majority of the clinical data and biosignals are collected from devices and carriers of disintegrated data. This, coupled with the lack of interoperability with applications like the Electronic Health Records and the use of paper instruments to support certain clinical management and care processes, obliges the healthcare providers to invest part of their time in manually saving data and creating reports and, moreover, causes a significant loss of information.

At this stage of the ehCOS SmartICU pilot run, the data and biosignals from 156 different devices, including monitors, ventilators and infusion pumps from various manufacturers, have all been integrated into a single, intuitive interface to increase accuracy in capturing data from the monitored patient and reduce information mechanization time in the management of nursing care and clinical reports by more than 10% in all cases.

According to Dr. Eduardo Vigil, Medical Director at everis and ehCOS and member of the research team of the project, “all of this data is now interoperable with the electronic health record of the patient, which helps doctors and nurses have a more complete vision of the patient, including their medical history, such as allergies, lab results, studies, etc. to conduct a more accurate comprehensive and sequential analysis of information.”


Figure. Smart ICU application: Patient vital data integrating screen
Unlike the bedside monitor or ventilator, the Smart ICU application shows not only realtime vital data, but complete patient historical data, always at the disposal of nurses and doctors for consultation and analysis

Usability: a crucial factor in technology adoption

One of the challenges in the implementation of technologies in the healthcare industry is user adoption. This is due especially to the complexity of the tasks and workflows that are developed, the stress levels of the environment, the productivity problems that may exist during the early months of implementation and the impact that inefficient usability can have on clinical productivity, error rates, user fatigue and overall dissatisfaction

The ehCOS SmartICU solution is already being used by 95 clinical care professionals and three ICUs of the Virgen del Rocio University Hospital. The first usability study conducted in this phase reveals that over 70% of users find the system easy to use.

Moreover, they recognize that it improves their productivity and efficiency by over 10% in tasks such as vital signs monitoring, care plans, checklists, medication, scales, water balance and losses, and clinical reports.

According to Maria Isabel Gonzalez, Chief of Nursing and Primary Nurse at the Virgen del Rocio University Hospital, “Until now, the nursing brain sheet was paper-based due to the lack of usability and dissatisfaction with the existing applications. The work we have done in ehCOS SmartICU with the software engineers has been crucial to achieving a well-designed, usable and intuitive application, which is facilitating the adoption of the system in several modules of critical care units”

At the threshold of predicting the most frequent critical situations in ICUs

Predicting the precise moment at which a critically ill patient will require a rapid and timely intervention by a health professional can avoid serious or irreversible episodes and save many lives.

“Data scientists at NTT DATA, in collaboration with the physicians and nurses at Virgen del Rocio University Hospital have developed predictive models for the most frequent critical episodes in intensive care units, such as acute hypotension, hypoxemia (low oxygen in the blood) and septic shock,” according to Dr. Francisco Murillo, Head of Intensive care at the Virgen del Rocio University Hospital and principal investigator of the project.

At present, the developed predictive algorithms are being tested with actual data provided for research purposes by tens of thousands of Intensive Care Units (ICU) to databases such as MIMIC (Multiparameter Intelligent Monitoring in Intensive Care), a project led by a multidisciplinary team of researchers from MIT, with the participation of leading organizations in the worldwide healthcare industry.

According to Tsuyoshi Kitani, EVP at NTT DATA Corporation, “We are aiming to offer the clinicians alerts for critical, frequent conditions of the ICU patients. Through these alerts we are actually providing them with essential time in deciding the approach to avoid a dangerous situation, based on the data, and the chance to administer timely medication and perform according procedures. We believe that early intervention is a key to improving the mortality rate of the ICU - to saving lives.”

In the upcoming months, the predictive algorithms will undergo validation with data obtained from the patients of the Hospital itself and then will go through a series of tuning techniques, which will raise the current level of accuracy. Using the validated and approved predictive models, we will build a mobile alert system, which will let clinicians know exactly when any of their patients is in danger of entering a serious complication. With this predictive application, we will start a new phase of the pilot from January 2017, which will bring an innovative improvement to the treatment of critical patients.

According to Mario Chao, CEO of ehCOS, “With this PoC result, we are planning to sell this solution as ehCOS SmartICU from this November. We will first target Spain and USA, and will afterwards expand the sale activity to Latinamerican and Asian countries”.


NTT DATA is a leading provider of IT services and a global innovation partner, headquartered in Tokyo, with business operations in over 40 countries. Our emphasis is on long-term commitment, combining global reach with local intimacy to provide premier professional services varying from consulting and systems development to outsourcing. For more information, visit

About everis

everis, an NTT DATA Company, is a multinational consulting firm providing business and strategy solutions, application development, maintenance, and outsourcing services. Currently, we rely on 16,000 professionals working in our offices and high performance centers located in 14 countries. As part of the NTT DATA group, everis can offer a wider range of solutions and services through increased capacity as well as technological, geographical, and financial resources that help provide the most innovative solutions to our customers. For more information, visit

About the Virgen del Rocio University Hospital.

With a 55-year history and a staff of more than 8,000 professionals, the Virgen del Rocio University Hospital is one of the largest health centers in Spain and the largest hospital complex in the Andalusian public healthcare system. This hospital serves a population of more than half a million people in the province of Seville and is a regional and national reference center for the most complex specialties and procedures. Each year the Hospital sees to more than 50,000 admissions, 310,000 emergencies, 61,000 operations, 1,000,000 consultations, approximately 300 transplants and 8,300 deliveries. For more information, visit

About ehCOS

ehCOS is a suite of innovative information technology solutions developed by everis for the healthcare industry, with a next generation patient-centered EHR at its core that optimizes the exploitation of data to facilitate the medical and administrative decision-making process and increase the safety and quality of care in healthcare organizations. The development of the suite is based on the innovative, award-winning “EXTREME compliance” (Extract, Transmit, Exchange, Move and Embed) architecture technology, and modular “LEGO” philosophy, providing an effective response to the information processing needs of the healthcare processes. For more information, visit


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