Article   |   January 29, 2015   |   Advanced ICU Care

Four Questions to Weigh Before Adopting Tele-ICU

Written by Lou Silverman, CEO, Advanced ICU Care | January 29, 2015
Originally appeared on mHealth News online

Given the disparity between critical care resource supply and demand, a growing number of hospitals are contemplating the clinical and financial benefits of tele-ICU. As with any clinical or business partnership, however, thoughtful analysis is important in the selection of an appropriate tele-ICU partner. Issues to explore include the amount of collaborative effort dedicated to ICU program goals, as well as how clinical “best practices” are developed to achieve optimal outcomes for all stakeholders.

Here are four questions a hospital’s leadership team should ask when assessing a tele-ICU partnership.

Question 1: What clinical and technology capabilities should hospitals evaluate?

Hospital leaders should take a holistic view of any tele-ICU collaboration. Consider aligning with a tele-ICU partner that demonstrates a clear understanding of how to build a successful clinical alliance – based on best practices – with the hospital’s critical care bedside teams. The needs and concerns of the bedside teams must be acknowledged, respected and clearly defined in the operating plan. It helps if the tele-ICU organization has a solid record of attracting and retaining highly experienced intensivists, nurses, nurse practitioners and other clinicians.

From a technology perspective, hospitals should look for a tele-ICU platform capable of supporting the entire clinical team. In addition, they should expect tele-ICU partners to have the necessary resources dedicated to technology integration.

Question 2: What clinical benefits does tele-ICU offer?

Working in collaboration with a bedside teams, tele-ICU can consistently demonstrate decreased mortality rates, reduced lengths of stay (LOS), fewer clinical complications and improved clinical measures.1 In fact, tele-ICU can help sustain improvements in mortality rates below what is predicted by industry-standard algorithms such as APACHE, and can offer similar results for LOS.

One key factor contributing to these benefits is the fact that tele-ICU supports bedside staff 24/7, enabling around-the-clock implementation of high quality care driven by best practices. At a time when many ICUs are adjusting to substantial staffing constraints, tele-ICU allows hospitals to offer more comprehensive care to patients and their families.

Question 3: What impact does tele-ICU have on critical care staffing?

A good tele-ICU program can effectively address many of the challenges created by lean staffing models and a high demand for critical care providers. Indeed, research indicates that the presence of a tele-ICU partner increases critical care staff satisfaction and decreases staff turnover rates—both of which are positive outcomes for a hospital.2 These results are seen in large part because bedside teams feel better supported when they know they can rely on additional eyes, ears and expertise in the ICU.

Question 4: What are the financial and operational benefits of tele-ICU?

Objective reporting on ICU performance is one benefit hospitals should expect from a tele-ICU partner. In many cases, those reports should reveal financial benefits from a combination of decreased patient LOS and increased patient throughput.

In addition, tele-ICU capabilities may allow hospitals to retain higher acuity cases, simply because they can provide more intensive care during a patient’s ICU stay. Thus, patients can stay closer to home, and hospitals can increase their case mix indices (CMI). It is a win-win situation that delivers a more satisfying care experience for patients and their families, while enhancing a hospital’s revenue and marketplace presence.

Positive answers for the ICU

A successful tele-ICU program is defined by effective collaboration, implementation of best practices, adherence to well-defined protocols and a shared commitment to improving patient outcomes. A well-designed tele-ICU partnership provides an opportunity for hospitals to improve both patient care and ICU operations, even in an environment where the need for critical care services outweighs the availability of critical care specialists.

Not all tele-ICU options are the same, however, so careful assessment is prudent. By considering these four questions, hospital leadership can make informed decisions that ultimately result in the effective utilization of tele-ICU.

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