By The collaboration between bedside and distant teams via tele-ICUs improves treatment and results.
Patients in remote intensive care units (ICUs) are connected with a critical care team (intensivists and critical care nurses) via real-time audio, visual, and electronic techniques, and health information is communicated. Tele-ICU has a command center that is located off-site. Similar to telemedicine, tele-ICUs are also gaining popularity rapidly.
What is tele-ICU?
A tele-ICU, in its most basic version, allows off-site doctors to confer with bedside personnel on patient care. One centralized care team may handle a large number of geographically distributed ICU sites in real-time by exchanging health information electronically. A tele-ICU, such as Philips E-ICU, is a supplement to the bedside team, not a substitute, and provides support to increasingly restricted clinical resources. During the COVID-19 pandemic, tele-ICU programs aided overloaded hospitals by having allowed them to treat more patients while reducing infection risk and PPE use. Tele-ICU programs are command centers fully equipped with intensivists and critical care nurses who digitally aid and deliver real-time information to frontline clinicians.
According to Dr. Benjamin Scott, a UCHealthanesthesiologist, tele-ICUs are an effective way to supplement limited resources in rural counties missing critical care expertise and urban areas experiencing temporary traffic surges.
During the public health crisis in New York, Northwell Health used tele-ICU infrastructure to assist bedside nurses, provide critical care direction to pop-up ICUs, and swiftly onboard two additional hospitals into the tele-ICU program. Northwell’s tele-ICU, which is already six years old, covers nearly half of the organization’s 400-plus ICU beds throughout a 23-hospital system, with ambitions to cover up to 300 total beds by next year, according to Iris Berman, vice president of telehealth services. The command center in Syosset, New York, has a broad scope: The remote team relies on eight monitors, two CPUs (half for high-quality video and half for documentation systems), sophisticated Phillips e-ICU software, and, in some cases, an intensivist for every 200 beds.
How does it work?
Tele-ICU programs pool clinical resources in distant care centers (a central monitoring facility) and deliver them to the bedside via technology, regardless of the location of the care center or hospital. A physician operating from a care center in New York City may quickly care for a patient in Seattle, day or night, using A/V conferencing and a real-time data stream of patient information from several interfaces. This link enables an intensivist who is already involved in the patient’s care to react quickly and consistently to best practices.
Is it cost-effective?
The tele-ICU model is one of the most quickly changing, according to research published in CHREST magazine, with about 51,000 patients examined in seven adult ICUs. According to a study, telemedicine is linked to lower mortality rates and shorter hospital stays. This study’s purpose is to look at the financial repercussions as well.
The following are the outcomes:
When compared to traditional models, a tele-ICU-managed ICU increased case volume by 21%.
Due to greater case volume, shorter durations of stay, and better case income relative to direct expenses, a centralized tele-ICU approach boosted contribution margins by 376 percent ($37.7 million vs. $7.9 million).
When a tele-ICU was co-located with a logistics center (to promote bed occupancy), case volume increased by 38 percent.
A tele-ICU with a logistics center and quality care standardization increased contribution margins by 665% ($60.6 million vs. $7.9 million).
In less than three months, the ICU telemedicine program’s initial capital expenses were recovered using this care delivery paradigm.
With E-ICU Outreach, small facilities may benefit from a tele-ICU
It’s easier than ever to conclude that a tele-ICU would be beneficial and perhaps cost-effective, but putting it into practice can be challenging. Previously, Tele-ICU solutions required a significant initial investment. However, any hospital, regardless of size, operational and technical capabilities, or intensivist personnel resources, may now implement the concept.
Many companies have recognized this, which is why the Philips e-ICU Outreach Program was established to connect smaller businesses with telehealth services provided by e-ICU programs at larger hospitals. We help a smaller organization build a partnership with an institution that employs a Philips e-ICU program to monitor its critical care beds and reap the benefits of an e-ICU program at a low cost.
Adoption of Tele-ICU necessitates a significant upfront financial investment, as well as continuing operations and maintenance costs. These expenditures, along with a lack of reimbursement and uncertainty over return on investment (ROI) estimates, might stymie the technology’s adoption. Furthermore, the ROI was estimated only based on indirect therapeutic benefits and the anticipated reduction in duration of stay. Return on investment indicators includes pay-back term and Net Present Value (NPV). More specifically, the following equation of financial issues associated with tile-ICU is desired.
