The intensive care unit is a unique environment in healthcare. With CVP’s and PA catheter data, constant urine output monitoring, labs obtained as frequently as every hour, care in the ICU is extraordinarily data driven. That characteristic makes it particularly amenable to remote monitoring. In a recent post , we covered the CMS decision to leave out critical care services in Medicare’s expansion of its coverage of telemedicine. In that decision, the lack of definitive positive outcomes data for tele-ICU’s won the day.
However, Mary Jo Gorman, CEO of Advanced ICU Care has a bit to say about that. In her article “The Future of Tele-ICUs: An Insider’s Perspective,” Gorman argues that tele-ICUs will emerge as the prime way to ease the predicted shortage of intensivist physicians. 50,000 patients die annually from preventable deaths in the ICU, and intensivists have been shown to significantly improve outcomes. With a shortage of 10,000 ICU physicians forecast, our health system needs to find a way to compensate and she arguesd tele-ICU’s may be part of the answer.
While the CMS may not be convinced just yet, Gorman points to tele-ICUs as an effective and efficient way to solve this problem. Tele-ICUs use cameras, video conferencing, and remote monitoring technologies to allow physicians and nurses to serve as surrogate intensivists for patients in ICUs that may not have access to dedicated ICU doctors 24/7. Staff at the remote center can link in and consult with attending physicians and alert them to changes in patient status that need attention.
Sentara Norfolk General Hospital in Norfolk, VA is just one example of this growing trend. Studies published by JAMA and the New England Healthcare Institute have shown that tele-ICUs do in fact improve patient outcomes in the ICU. Economically, they will no doubt offer cost savings – the dedicated tele-ICUs can monitor many hospitals at once, taking advantage of economies of scale.
While Gorman offers a compelling argument for tele-ICUs, we should take her words with a grain of salt. As a former intensivist physician, she has very valuable insight into how ICUs function. But as the CEO of a private tele-ICU company, she has the obvious incentive to market her company’s product. With looming budget cuts to Medicare and the enormous pressure on our health system to contain costs, mHealth will no doubt become increasingly integrated into the delivery of care in ICUs.