Beginning in 2020, Oregon Health and Science University (OHSU) and General Electric Healthcare (GEH) collaborated on the creation of the OHSU Virtual Intensive Care Unit (VICU). Ultimately, the purpose of the VICU is to allow OHSU to provide real-time, remote, telecritical care support to regional medical centers throughout Oregon in order to facilitate local care of complex patients. To implement this system, OHSU has partnered with GEH as the initial test site of the GEH Mural? platform, which integrates continuous telemetry from all patient-connected devices, laboratory values, and a real-time audio/visual feed into a single computer interface. To better characterize the effectiveness of the VICU, and as a demonstration of the type of analysis made possible by continuous and unified telemetry, we are conducting a quality-of-care investigation measuring time-percentage adherence to the ARDSNet protocol of mechanical ventilation before and after the addition of continuous registered nurse (RN) monitoring.