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Impact of telemedicine in the high-stakes, high-cost ICU

November 16, 2016
From the November 2016 issue of HealthCare Business News magazine

By Lou Silverman

The disruption and evolution of the U.S. health care system toward value-based care continues to drive opportunities for innovation and creative partnerships. Strategic partnering has always been important to how hospitals function, but now, more than ever, specialized service providers are supporting new models of care delivery that demonstrate improvements in quality, outcomes, cost and revenue, and improved job satisfaction for nursing staff and physicians. Telemedicine is emerging as an important example of a technology-enabled service that can achieve the seemingly at-odds objectives of elevating care while improving financial efficiency.

Recent data and real-world examples suggest that even in a high-stakes, high-cost area of the hospital, the ICU, telemedicine services are having a positive impact. The ICU usually represents a disproportionate share of a hospital’s total operating costs. On average, ICUs account for only about 10 percent of beds, but approximately 30 percent of costs. ICU leaders are expected to take steps to achieve 24/7 intensivist oversight, optimize processes and elevate the standard of care in a way that not only improves patient outcomes, but also achieves cost savings through fewer costly complications and reduced length of stay (LOS). This push to continually improve the quality of care in a department that is considered the key escalation point within the hospital, while doing so in a fiscally responsible manner, forces hospitals and health systems to evaluate and re-engineer their ICU delivery models.

Telehealth technology is emerging that can support models that can have dramatic impact, such as reducing ICU mortality 30 to 40 percent. These results are achieved through a continual collaborative 24 x 7 x 365 care tele-ICU model that connects bedside care providers and systems with intensivists and critical care nurses working in a tele-ICU care center. This highly engaged approach operates around the clock with a seamless interface to hospital systems including the electronic health record, pharmacy and bedside monitors, to ensure that a constant stream of patient data is available to the tele-ICU team.

This high level of connectivity enables an ongoing clinical partnership to be created in which informed, remote care teams co-manage patient care 24 hours a day. In addition, the tele-ICU data flow enables information aggregation and multi-level reporting of performance metrics. Rather than simply being reactive to inbound requests from the bedside team, tele-ICU clinicians can leverage technology to more rapidly detect adverse physiologic trends and initiate recommended or required care procedures, all of which can improve outcomes and avoid adverse events.

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