Building the future of ICU care: Is our digital foundation strong enough? A multicentre survey of Australian and New Zealand intensive care units

Objectives: The objective of this study was to assess data-related resources, infrastructure, and capabilities in Australia and New Zealand (ANZ) intensive care units (ICUs). Design: Electronic multicentre survey was conducted. Setting: ANZ ICUs between June and October 2024. Participants: All ANZ ICUs contributing to the Australian and New Zealand Intensive Care Society Adult Patient Database and/or Australian and New Zealand Paediatric Intensive Care Registry were included in this study. Interventions: There are none to declare. Main outcome measures: The main outcome measures included types of medical records, digital data capture and research availability, digital enhancement plans, staffing, and research collaboration. Results: Of 209 ICUs, 112 (54%) responded; 13 paediatric, 21 mixed, and 78 adult ICUs, with responses from all ANZ jurisdictions. Overall, 59% used paper records (5 paediatric and 61 mixed/adult), 28% digitised (7 paediatric and 24 mixed/adult), and 59% electronic health records (EHRs; 10 paediatric and 56 mixed/adult), with most EHRs introduced within the last decade (76%). In units with an EHR, 59% collected data secondly or minutely in the EHR and >75% collected EHR data on patient demographics, clinical notes, laboratory results, medications, fluids, bedside monitors, and respiratory support devices. Data Managers were employed within 45% of ICUs, with 96% able to extract data for audit and 92% for research. Respondents reported frustrations with delayed EHR implementation and limited data extraction mechanisms. Conclusions: Substantial variability exists across ANZ ICUs in digital health adoption, data capture, and data management resources. Quantifying differences in digital information, improving data extraction, and building collaborative networks are key steps for supporting research and innovation across units.