Summer 2010 Newsletter

What's New

Three hospitals go live with virtual ICU program

Three hospitals, from Georgia to Wisconsin, have recently begun using the Advanced ICU Care virtual ICU program. Satilla Regional Medical Center in Waycross, Ga., and Wisconsin's Divine Savior Healthcare in Portage and ProHealth Care's Waukesha Memorial in Waukesha have all implemented the program to enhance patient care and safety and support the bedside clinicians in implementing best practices in the ICU.

Across the three hospitals, 52 ICU and cardiac care patient rooms have been outfitted with the technology. Additionally, to ensure continuity of care for critical patients upon arrival in the emergency department (ED) and through to the ICU, Satilla Regional Medical Center has implemented the program in three ED beds. Also supporting the emergency department, Divine Savior is utilizing mobile cart technology to provide critical care support and assist in the evaluation and care of critical patients in its emergency room.

The program underscores all three hospitals' commitment to utilizing advanced technology and a multidisciplinary, evidence-based approach to care to enhance outcomes in the ICU.

Critically speaking: Advanced ICU Care physicians share expertise at industry conferences

Advanced ICU Care physicians shared their expertise at several industry conferences this spring, including the Society of Hospital Medicine's annual meeting, the American Telemedicine Association conference and the St. Louis Gateway 2 Innovation annual IT conference.

At the ATA conference, Advanced ICU Care Virtual ICU Director Dr. Elizabeth Cowboy was asked for her input on the Centers for Medicare and Medicaid Services (CMS) initial rules for telemedicine. Dr. Cowboy and more than 200 other physicians and healthcare organizations responded to the call and the initial rules - which would have added to the burden of credentialing, particularly for small hospitals - were overturned. Moving forward, Dr. Cowboy, along with Dr. Gorman, Advanced ICU Care President Dave Schopp and Credentialing Specialist Kris Wilson, will be taking part in an official brief to CMS to outline the future of the new regulations.

Advanced ICU Care makes list of fastest growing private companies; continues to add to clinical and operations teams

Advanced ICU Care was ranked No. 3 in a list of the fasting growing private companies in St. Louis. The list, published by the St. Louis Business Journal, ranked companies by the percent increase in revenue growth from 2007-2009.

As it continues to grow, Advanced ICU Care is expanding its clinical team to support local clinicians in caring for patients, having recently added talented nurse practitioners and other clinical staff. The company has also been focused on adding key positions in operations to support its clients.

Advanced ICU Care deepens management team with Dr. Elizabeth Cowboy

Elizabeth Raitz Cowboy, M.D., MSOD, FCCP, has joined Advanced ICU Care as director of the virtual ICU. In this pivotal new role, Dr. Cowboy ensures outstanding performance on clinical standards and client service, delivers consistency in operations and builds communication and interaction among stakeholders.

An industry leader in critical care telehealth, Dr. Cowboy's background includes medical director for the virtual ICU program at both Via Christi Health System and Inova Health System, as well as activation support physician for eICU site implementation.

Features

The Bottom Line: Are physicians ready for relief in the ICU?

Between the physician shortage - which is about to get worse given baby-boomer retirements, according to a recent Washington Post article - and the widely reported increase in patient demand brought on by healthcare reform, some physicians could be ready for relief. Particularly hospitalists, says Advanced ICU Care's Mary Jo Gorman, M.D.

Studies show intensivist care in the ICU improves patient outcomes, yet fewer than 20 percent of U.S. hospitals have intensivists on staff. Meanwhile more than 60 percent of hospitals have hospitalists on staff. For some, this is where a majority of the ICU workload can fall.

At Saint Clare's Hospital in Weston, Wis., hospitalists manage a large majority of inpatient admissions. But in the ICU, the hospitalists and other clinical staff are supported around the clock by remote intensivists, through the virtual ICU program. Saint Clare's hospitalists drive patient care plans and often take care of daily issues, while intensivists and critical care nurses in St. Louis monitor patient care data 24/7. Through the technology, they are able to identify subtle changes in a patient's condition and uncover potential problems before they develop further.

Having virtual team members in the ICU allows hospitalists to focus on hospital patients outside the ICU. And for those patients in the emergency room, the hospitalist / virtual intensivist team can provide continuity of care as the patient is admitted in the emergency department and transferred to the ICU. And because Advanced ICU Care intensivists are available day and night to respond to calls from the ICU, physicians covering the ICU are afforded considerable relief.

For Saint Clare's, having the virtual ICU care program has meant actual ICU mortality rates have averaged 45 percent lower throughout 2009 than the mortality rates predicted by patients' APACHE IV scores. The ICU length of stay averaged 30 percent lower than predicted for 2009.

While Saint Clare's made the decision to adopt a virtual ICU program, other solutions presented by Dr. Gorman at SHM included hiring intensivists (an often difficult task given recruiting challenges), using what is on hand, and finding allies in nursing, administration and other medical staff. Using what is on hand, Dr. Gorman believes, means appointing someone accountable (ideally an ICU medical director), using the team (including respiratory therapists, nurse practitioners, pharmacy and others) and incorporating daily multidisciplinary rounds and goal-directed care into the process.

In the News

Advanced ICU Care client hospitals continue to demonstrate their commitment to investing in quality and technology to deliver the best possible care for patients in their communities. Below are some recent articles highlighting the virtual ICU programs and their impact on patient care outcomes, hospital financials or staff retention/satisfaction.

Warner Robins Patriot.com: Houston Healthcare first state medical system to add eICU

Houston Healthcare is wired ... not only internally but, since Dec. 15, connected to an agency in St. Louis, Mo., for continuous, real-time monitoring of intensive care patients at hospitals in Warner Robins and Perry. (more)

Physician Executive Journal: Virtual ICU Case Study: St. Mary's Health Center

Discover the quality improvements and revenue increases that officials at a hospital in Missouri credit to the implementation of a tele-intensivist program in the ICU. (more)

ADVANCE for Nurses.com: Virtual reality with eICUs

This technology offers nurses an extra level of clinical resource and patients and family members' reassurance that our patients are receiving exceptional care. (more)

Experts at Advanced ICU Care have also been leading voices in healthcare. Click on the links below for recent articles on ICU transfers and the need for better observation, as well as nursing management.

Medscape.com: Unplanned ICU transfers often preventable but not typically due to clinical error

...Mary Jo Gorman, M.D., MBA, founder and chief executive officer of Advanced ICU Care, based in St. Louis, Mo., told Medscape Internal Medicine that the results are not surprising, but she agreed that they point to the need for better observation and a quicker response to changes in the patient's condition. (more)

ADVANCE for Nurses.com: Tips for new nurse managers

Patricia Frasca, RN, is clinical operations lead for Advanced ICU Care in St. Louis. "One thing that's important is to know who your go-to people are for advice," said Frasca -- particularly HR resources. "You need to know who you can rely on to help mentor you." (more)