by John Terry
October 6, 2006
St. Louis Business Journal
Caring for the critically ill is Dr. Isabelle Kopec's passion. A pioneering member of a relatively new and still relatively small medical subspecialty -- intensivist -- Kopec is using telemedicine to increase the survival rates of the sickest of the sick.
"It's a subspecialty of internal medicine, anesthesia or surgery," said Kopec, 50, who also serves as chair of the department of critical care medicine and president of the medical staff at SSM DePaul Health Center in Bridgeton.
"It's essentially critical-care medicine. It arose because we have so much technology and so many medications associated with the intensive care unit (ICU), that it's very difficult for a generalist to keep up on all of that. And so much of how patients do in intensive care depends on recognizing problems early and intervening early, and so this subspecialty grew."
Its role, Kopec said, is not to supplant but to augment the care provided in ICUs by the existing medical staff.
"What you really need is someone who knows all the organ systems and how they work together in critical illness and can address all of them," she said. "We do pretty much all the procedures that patients need in the intensive care unit, not in the operating room. There's a lot of literature out there now that demonstrates that if you're managed by an intensivist when you're in the ICU, you have a better chance of surviving. Mortality goes down by about 30 percent."
As word of the successes that intensivists are producing has spread, the demand for their services has risen. Still, only one in five ICUs nationwide is currently staffed by them. "There aren't enough of us to go around," Kopec said. "That's what started our venture into the electronic ICU."
In 2005, Kopec and a group of physicians and health-care professionals formed Advanced ICU Care, a medical services company connecting board-certified intensivists to hospital ICU patients through "telemedicine" technology, by which they provide remote monitoring and virtual care of patients by cameras and microphones, 24 hours a day, seven days a week. Kopec said two hospitals, one in Wisconsin and one in Jefferson City, Mo., currently are using the company's services, and one in Indiana is expected to sign on soon.
"By connecting electronically to the hospital ICU and the patient's bed, we can bring our expertise to hospitals anywhere in the United States," she said. "The way it works is, we have a bank of computer screens. We look at the patient visually. There's a camera with a microphone, so we can speak to the patient, the family, the physicians and the nurses. And we also have electronically all their information, so we know everything about the patient as if we were at their bedside looking at their medical records."
Kopec said there about 6,000 intensivists in the United States and some 30 electronic ICUs comparable to her company, Advanced ICU Care. But she said hers is the only one that is privately owned and not associated with any hospital system. All of the others, she said, have been set up by a hospital system specifically for that system.
Advanced ICU Care has a total of 31 employees. Kopec declined to disclose the firm's revenue.