Collaborating Across the Miles

Hospitalist (American College of Physicians)
April 1, 2008

Richard Bailey, FACP, medical director of inpatient care and hospitalist services at Saint Clare’s Hospital in Weston, Wis., was called to the emergency department in the middle of the night to see a man with a drug overdose. Dr. Bailey intubated and stabilized the patient and got ready to admit him to the 12-bed intensive care unit (ICU). He called an intensivist on duty—a doctor stationed at a remote ICU (eICU) command center more than 500 miles away in St. Louis. “I was able to call the command center, have them ‘meet’ me [on camera] in the patient’s ICU room and immediately join me in the management of the patient,” said Dr. Bailey, a hospitalist. Saint Clare’s is one of a growing number of hospitals in the U.S. that are using remote monitoring systems to help oversee the care of critically ill patients. The trend is being driven by a number of factors, including the tight supply of intensivists to staff ICUs and a desire to improve care while reining in costs. Proponents of the systems say that eICUs can reduce complications, length of stay and mortality rates. Community hospitals that have eICU backup also are able to keep critically ill patients rather than transfer them, which can bring in added revenue and is often more desirable for the family. Wendy Everett, president of the New England Healthcare Institute, a nonprofit research organization in Cambridge, Mass., said her group is starting a study with UMass Memorial on the impact of tele-ICU care at the community hospital level. Most of the reports on decreased mortality came from large integrated health systems, she noted, and the dramatic results reported in early studies have not been replicated independently. Also, not much is known about the potential benefit to community hospitals. “Even though the full spectrum of evidence is not quite complete,” Dr. Everett said, “the early results are very promising. We’re extremely optimistic about the potential of tele-ICUs to save lives and save money.”

Link to Full Article: http://www.acponline.org/clinical_information/journals_publications/acp_hospitalist/apr08/collab.htm