Dr. Michael Walter, M.D., intensivist at Advanced ICU Care, and Mary Jo Gorman, M.D., M.B.A., chief executive offi cer and founder of Advanced ICU Care, are pioneers in the application of telemedicine in the ICU.
for a call back, they have instantaneous access to an intensivist.” Dr. Hegland attributes the strong clinical and operational results to three factors: • With the tele-ICU program, pa- tient care plans are managed 24 hours a day, as opposed to the interventions being limited to the morning and the evening, when the bedside physician was present in the traditional bedside model only. This moment-by-moment assessment of critically ill patients whose conditions are changing rap- idly provides the quick intervention that is needed to prevent deteriora- tion and stabilize them. In addition to the monitoring of patient data, the technology contains algorithms that identify and send automatic alerts when a patient’s condition indicates that immediate attention is needed. If a nurse needs help right away, an emergency button in the patient’s room can be pushed to
summon a physician via the video in the room.
• The remote-monitoring team and the bedside team truly work together collaboratively. From the beginning, the focus was on cooperation with and support of the local physicians and the nursing staff. Because of this collaboration, the program comes together seam- lessly for benefi t of the patient.
• The team approach encompasses process-improvement initiatives that ensure that evidence-based medicine and best practices are instilled throughout the ICU. The results are a reduction or avoidance of most of the common complications that can occur in this high-acuity environment. For example, incidences of ventilator- associated pneumonia are almost non-existent.
In a large study of more than 10,000 patients across multiple hospitals, Ad- vanced ICU Care demonstrated an
HEALTH MANAGEMENT TECHNOLOGY
average performance of: • 40 percent reduction in mortality in the ICU;
• 25 percent reduction in length of stay;
• 17 percent increase in the number of ICU cases; and
• Continuous process improvement that reduces complications, in- creases throughput and improves patient and staff satisfaction. “The tele-ICU combined with process-improvement programs are really the future of ICU healthcare,” says Dr. Hegland. “As we go into an era of increasing physician shortages, we’re going to see more and more of these kinds of innovative programs in hospitals. And physicians, nurses and patients welcome them. The intensiv- ists and hospitalists have commented that if this program weren’t in our hospital, they wouldn’t be either. Mak- ing the decision to adopt a tele-ICU program is one of the best a hospital will ever make.”
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