Using telemedicine to serve the critical care needs of rural communities total has saved millions of dollars while significantly improving patient survival, according to a new study conducted by Avera eICU CARE, a service of Avera Health based in Sioux Falls, South Dakota. The study, presented at the recent Society of Critical Care Medicine's annual meeting, involved Avera McKennan Hospital & University Health Center in Sioux Falls and rural hospitals in the Avera eICU network.
“The health care quality and safety benefits of ICU telemedicine have been well documented,” said Dr. Edward Zawada, medical director of Avera eICU CARE and an author of the study. “What is becoming evident are the significant financial benefits that can accrue from this improved quality. Equally important are benefits like less stress on rural physicians and nurses, and higher patient and family satisfaction.”
Data was compared before eICU implementation, and 30 months after implementation. Among the findings:
— Rural hospitals estimated a 37.5% reduction in the number of patients requiring transfer, representing a cost savings of more than $1.2 million.
— Reduced length of stay in Intensive Care Units saved an estimated $8 million.
— ICU and hospital mortality rates were 65-80% lower than predicted outcomes after implementation of the eICU, compared to 50% lower than predictions before implementation.
— 90% of rural hospital clinical leaders surveyed reported being more comfortable caring for critically ill patients with eICU.
— 90% of rural hospital leaders surveyed agreed that patients and families are comfortable staying in the hospital with the added eICU care.
— 100% of rural physicians surveyed agreed that better, safer care can be supported by a remote critical care team.
While numerous studies documented by the Leapfrog Group show that intensivist staffing reduces the risk of ICU mortality by up to 40 percent, a shortage of intensivists makes such bedside care impossible in most locations. With only about 6,000 of these specialists in practice, less than 15 percent of ICUs have dedicated intensivist care. This is especially true in rural areas, which represent close to 25 percent of the population, yet have only 10 percent of the nation’s physicians.
The eICU Program, by Philips VISICU, is designed to make specialized care by intensivists more widely available. When it opened in 2004, Avera’s eICU was the first system of its kind in a Midwestern rural setting. Avera eICU® CARE provides tele-intensivist care to 16 hospitals across a rural four-state area, including seven community hospitals and eight Critical Access Hospitals.
“These results show that we can leverage scarce physician resources across rural areas, said Dr. David Kapaska, senior vice president and chief medical officer at Avera McKennan. “We have seen reductions in mortality and cost that have saved lives and more than covered the cost of the investment.”