The lack of around-the-clock ICU coverage and a shortage of intensivists is a pressing issue for many community hospitals, particularly those that are mid-size. Fewer than 20 percent of ICUs are staffed with intensivists, according a report from The Hospitalist, making a case for teleintensivists — or intensivists who practice medicine via interactive audiovisual equipment. Tele-ICUs link physicians and nurses in a command center to ICU patients in distant units. As of 2010, approximately 249 hospitals had adopted a Tele-ICU program, according to the National Network for Health Innovation.
Here are five ways an ICU telemedicine program can help a hospital save money, improve physician relationships and offer more efficient patient care.
1. Frees up resources, physicians for coordinated care. With healthcare reform and the emergence of accountable care organizations, hospitals are shifting their focus to the continuum of care, improved quality and lower costs. “Telemedicine allows hospitals to better deploy physicians in their community,” says Mary Jo Gorman, MD, CEO of St. Louis-based Advanced ICU Care, a company that brings board-certified intensivists to hospital ICUs through telemedicine technology. Tele-ICUs can solve shortage problems in areas requiring intense resources, better enabling ACOs to meet performance goals.
2. Improves physician recruitment capabilities. Physicians can face a considerable amount of difficulty when it comes to work-life balance. “There are many calls for physicians in the middle of the night from the ICU. These are high-acuity patients, so they really have to respond promptly,” says Dr. Gorman. An ICU telemedicine program alleviates some of this stress for the physicians during the night and can act as a back-up during weekends. Physicians working at hospitals that have launched Advanced ICU Care programs have reported increased lifestyle satisfaction and willingness to practice longer, making tele-ICUs effective recruiting tools for hospitals.
3. Reduces patient complications and costs. A telemedicine program, particularly one for ICUs, can also lower patient expenses by reducing complications. Hospitals that have implemented Advanced ICU Care have, on average, seen a 25 percent reduction in the length of patient stay in the ICU. This decreased patient stay reduces complications, which also lowers costs. “When a patient is on a respirator, they’re very vulnerable. With our program, they’re on a respirator for a lesser period of time. By avoiding that complication, the hospital saves money that would have been spent on antibiotics, surgery or testing,” says Dr. Gorman. The average Advanced ICU Care client has also seen 40 percent reduction in patient mortality and 17 percent volume growth in the ICU, according to Dr. Gorman.
4. Helps retain patients. It’s crucial for mid-sized community hospitals to retain as many patients in their community as possible. “If you don’t offer a certain level of service, those patients will either visit elsewhere or be transferred elsewhere,” says Dr. Gorman. This is particularly true for critical access hospitals in rural areas — facilities which might only have one or two ICU beds but a significant intensivist shortage. Community hospitals may already transfer patients elsewhere for certain specialties, such as neurosurgery, but can retain ICU patients due in part to the 24/7 availability of teleintensivists.
5. Location and market do not factor. Unlike most healthcare affiliations or partnerships, telemedicine programs do not involve geographic restrictions by any means. Dr. Gorman says Advanced ICU Care clients are spread throughout the country, including sites in New Mexico, Oregon and South Carolina.