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Ministry St. Clare’s Hospital might be tucked into a remote corner of Wisconsin, far away from the hustle and bustle – and resources – of an urban center like Madison or Chicago. But that doesn’t mean its patients shouldn’t have access to 24-hour-a-day intensive care.
That’s the thinking of the hospital’s Chief Medical Officer, Larry Hegland, MD, who helped launch the hospital’s tele-ICU unit in 2006. Six years later, the Weston, Wis.-based hospital is known for having one of the longest-running tele-ICU programs in a community hospital in the United States, and it’s starting to show results that prove the success of the telemedicine program.
“It’s evolved into just the normal way of doing things,” says Hegland, who came to the hospital in 2004 with a goal of making it an all-digital facility. “But it’s not just about launching a telemedicine service – that’s not how it works. It’s more about establishing a partnership that works.”
When Ministry St. Clare opened its doors, the hospital had one intensivist on staff who worked from 8 a.m. to 5 p.m. The rest of the time, the hospital contracted with Advanced ICU to ensure proper off-hours coverage for 19 hours a day. The hospital has since expanded that to 24-hour-a-day coverage, giving staff an almost-immediate link to resources that include ER physicians and specialists.
Hegland says it was important to coordinate meetings between the hospital’s staff and Advanced ICU physicians, so that everyone was on the same page and receptive to the partnership. He said the Advanced ICU physicians started by providing consultative services, and gradually took over management duties as they became familiar with Ministry St. Clare’s operations.
‘There’s nothing on the horizon that says the (physician) shortage is going to get any better,” he adds. “And in a rural setting with remote, small communities, this becomes a very important and very viable solution.”
“Telemedicine as a solution to the physician shortage is much more accepted now,” says Mary Jo Gorman, Advanced ICU’s CEO. “ICUs around the country, frankly, are in a crisis, and in small community hospitals there’s a disadvantage in not being able to find or attract the right talent. (Telemedicine) gives them the ability to meet those challenges.”
According to Advanced ICU and Ministry St. Clare officials, the hospital’s tele-ICU services have enabled Ministry to improve its ICU mortality, hospital mortality, ventilator days and length of stay for both the ICU and the hospital. Other improvements reported by hospital officials include an increase in ICU capacity, improvements in nursing recruitment and retention, improved documentation and reduced readmissions.
That’s consistent with a study by the New England Health Institute, which found that tele-ICU programs achieve significant savings for the hospital and payers within the first year, as well as reducing ICU mortality by more than 20 percent and length of stay by 30 percent.
“Our nurses love it – they’re never more than 15 seconds away from talking to a physician,” said Hegland. “If I tried to take it out now, I’d have people rioting.”
While Ministry St. Clare is one of Advanced ICU’s earlier partners, the St. Louis-based company has been adding health systems to its customer base on a regular basis. The company has announced agreements to provide tele-ICU coverage to Atlanta’s Southern Regional Medical Center in March and the South Carolina-based Tuomey Healthcare System in April, and in January the company began offering tele-ICU services at Rockford Memorial Hospital in Rockford, Ill., and St. Mary’s Hospital of Centralia, Ill., part of the St. Louis-based SSM Health-Care network.
"The Advanced ICU Care team serves as an on-call partner providing a second set of eyes on our ICU patients," said Rajendra Shroff, internal medicine specialist at St. Mary's Hospital, in a press release. "This extra layer of care reassures doctors that their sickest patients are vigilantly monitored when they are not present. There is a deep sense of relief knowing that emerging issues are dealt with immediately, and patients are receiving the highest recommended level of care at a moment's notice."
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