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General FAQs
Follow the links below to navigate directly to specific questions.
- What is telemedicine?
- What is a tele-ICU?
- What is an intensivist?
- Why was Advanced ICU Care formed?
- What technology does Advanced ICU Care use?
- What benefits related to quality improvement have been achieved by hospitals that have implemented a tele-ICU?
- Who does procedures/emergency procedures if they are needed?
- What impact will Advanced ICU Care's program have on private attending physicians at our hospital?
- What are the financial benefits of the Advanced ICU Care program to your hospital partners?
- What factors are key to the success of the Advanced ICU Care Program?
- Will the Advanced ICU Care program make my hospital Leapfrog compliant?
- What benefits can be expected from the Advanced ICU Care program?
What is telemedicine?
Telemedicine applies audio and video applications to patient and healthcare providers' interactions. Telemedicine may be used for continual care, such as the Advanced ICU Care program used for the evaluation of specific problems to enhance diagnosis and treatment decisions, such as consultation with a specialist.
What is a tele-ICU?
A tele-ICU uses telemedicine technology that combines clinical management software with telemedicine care tools - including patient data and video feeds - to allow intensivists and critical care nurses to care for patients in hospital ICUs. Data is collected on a continuous basis and trends in patient status are collated and responded to in real time. This allows for urgent and emergent issues to be addressed immediately. Advanced ICU Care is the only stand-alone, private practice providing national tele ICU services 24/7. The depth and the maturity of our program are unmatched. We have implemented our tele-ICU program at 22 hospitals in 10 states.
What is an intensivist?
Intensivists are physicians who have received training in critical care beyond their primary residency. They initially train in and receive board certification in a specific medical specialty, such as surgery, internal medicine, pediatrics or anesthesiology. Subsequently, they train in and obtain a subspecialty certification specifically in critical care medicine. A unique feature of the training is collaboration with others to deliver optimized patient care. Intensivists deliver care in a hospital's intensive care unit (ICU), partnering with critical care team members, including other consultant physicians, critical care nurses, pharmacists and respiratory therapists. They are generally the team leader, facilitating all members to meet the patient's complex needs. They are specially trained on all the organ systems, as well as the medications, procedures and technology specific to the treatment of critically ill patients. They also help to set policies, develop protocols and facilitate communication within the ICU. Studies show that care by intensivists greatly improves the quality of care in the ICU. According to The Leapfrog Group, which has identified intensivist staffing as one of its "safety standards," more than 54,000 ICU deaths could be avoided if this standard were implemented.
Why was Advanced ICU Care formed?
The management and medical staff of many hospitals have experienced the difficulty and frustration of attempting to recruit a sufficient number of intensivists to staff their ICUs. The difficulty in recruiting intensivists to many hospitals is due to: the nationwide shortage of critical care medicine physicians; the abundance of opportunities in major metropolitan areas where many of these physicians have trained; and the reluctance of some intensivists to practice in a hospital without high acuity and volume. To address these challenges, Advanced ICU Care was formed. The company delivers intensivist expertise to ICUs through the use of sophisticated clinical management and communications technology, along with a process improvement program.
What technology does Advanced ICU Care use?
Our technology platform was developed by Philips VISICU, Inc. The technology combines clinical management software with patient data and real-time video feeds, enabling the care and monitoring of critically ill patients. The technology has proven itself even over long distances.
Part of the technology platform is the eCareManager™, a dashboard view of key patient information such as vital signs, physiologic data, medications, lab results and more ― giving clinicians the data they need to provide patient care. Telemedicine care tools, such as cameras and videoconferencing, allow tele-ICU physicians and nurses to see and communicate directly with patients, families and onsite clinicians. The system also provides automated alerts, which identify potential patient problems and allow physicians to intervene earlier.
Advanced ICU Care's tele-ICU Monitoring Center, located in St. Louis, is staffed by intensivists and critical care nurses who monitor patients throughout the country.
What benefits related to quality improvement have been achieved by hospitals that have implemented a tele-ICU?
It is clear from medical literature that the best outcomes in the ICU come from the involvement of intensivists. However, less than 30 percent of ICU patients have an intensvist involved in their treatment.
A study by The Leapfrog Group shows that more than 54,000 ICU deaths could be avoided if intensivists were on staff in every ICU.
ICU patients have lower risks of death and shorter ICU and hospital stays when an intensivist physician is on duty.
Advanced ICU Care's intensivist-led program helps hospitals improve patient outcomes and support continuous quality improvements. Our hospital partners have found:
- 40 percent reduction in ICU mortality on average
- APACHE performance for ICU mortality is 25 percent better than predicted and performance for ICU length of stay is 14 percent better than predicted
Our partners have also found improved best practices for:
- Sepsis management
- Ventilator-associated pneumonia (VAP) prevention
- Glucose management
- And many others
Who does procedures/emergency procedures if they are needed?
All hospitals have processes in place to deal with common emergency procedures. These include dedicated in-house personnel (physician assistants, critical care nurse practitioners, house physicians, hospitalists, anesthesiology personnel and emergency department physicians) or specialty physicians on call from home (cardiologist for pacemakers, etc.). These processes remain in place, except that the call for the procedure would likely be initiated by the intensivist at the tele-ICU after discussion with the attending physician. If surgical evaluation is required, the process is the same - the tele-intensivist contacts the surgeon requested by the attending physician. Tele-intensivists coordinate these activities, maintaining the nurse at the bedside.
What impact will Advanced ICU Care's program have on private attending physicians at our hospital?
The system is designed to support local physicians and their patient care and reactions to the program among our hospital partners and their staffs have been overwhelmingly positive. Advanced ICU Care has improved work-life balance for the healthcare professionals at the bedside. With the tele-ICU program's 24/7 intensivist monitoring, local physicians supporting the ICU experience fewer ICU call interruptions. A common practice is for tele-intensivists to field calls from the ICU at night and on weekends. Local physicians often discover that the number of calls interrupting their nights, office hours and operating room time declines dramatically. Likewise, the 24/7 support also gives bedside nurses more opportunity to provide direct care to patients and their families and provides them with ongoing resources. Hospital partners have seen reduced turnover among nursing staff.
There is also no effect on billing of professional fees. The attending physician maintains the authority to set the daily care plan. The role of Advanced ICU Care's program is to facilitate and expedite the local physician's care plan while enabling him or her to conduct his or her hospital/office practice more efficiently. Specific protocols for tele-ICU intensivists are developed during implementation.
What are the financial benefits of the Advanced ICU Care program to your hospital partners?
Advanced ICU Care consistently brings measurable improvements in financial performance and ICU efficiency. These accomplishments come from considerable reductions in length of stay, decreased mortality rates and fewer patient complications, as well as increased throughput and patient flow. Our hospital partners have found:
- 25 percent average decrease in total time spent in the ICU
- Average increase in ICU volume of 17 percent
- Increase in CMI due to improved documentation from ICU-specific EMR
- On average, Advanced ICU Care hospital partners have seen a 17 percent increase in patient volume, allowing the ICUs to bring in more revenue as they treat more patients. By increasing patient throughput, client hospitals can avoid the expansion of the ICU - with an average cost of $1.5 million per bed.
- A recent NEHI study found that tele-ICU pay for themselves in the first year and have an average improvement in the contribution margin of more than $2,500 per ICU admission
What factors are key to the success of the Advanced ICU Care Program?
The participation of key members of the medical staff, especially physicians most frequently using the ICU, in the decision-making process is important to success. Additionally, participation of the ICU nursing staff, ancillary departments and key medical staff members during implementation is very important. Advanced ICU Care provides experienced clinical and technical staff to support hospital workgroups during this process.
Will the Advanced ICU Care program make my hospital Leapfrog compliant?
Implementing the Advanced ICU Care program may enable your hospital to become Leapfrog compliant. Hospitals that use intensivists via telemedicine achieve partial recognition by The Leapfrog Group. Depending on the additional ICU resources, the hospital may achieve full compliance.
What benefits can be expected from the Advanced ICU Care program?
The benefits of the program are:
Clinical Expertise and Results:
- Clinicians with over 100 years of ICU management leadership
- Saved lives through continuous 24/7 monitoring and support
- Decreased length of stay in the ICU
Financial Impact:
- Increased efficiencies to allow more patients to be treated
- Reduced costs
- Improved throughput and increase revenue
Employee Satisfaction:
- Improved doctor and nurse recruiting through reduced strain on their lives
For additional information contact:
Emily Lynn
Inside Sales Support
Advanced ICU Care
999 Executive Parkway, Suite 320
St. Louis , Missouri 63141
Toll free: 866-394-6100
Local number: 314-514-6000
E-mail: info@icumedicine.com / communications@icumedicine.com