Dr. Brian Goltry is the first to say he was a “non-believer” in the concept of the tele-ICU a year ago, when he and a partner went to look at the technology in use at a South Dakota site.He came back a believer. And his leadership on the use of this powerful emerging technology ever since has been key to St. Luke’s participation, launched this morning across St. Luke’s Health System.
“We saw the system work,” he told a group of us who gathered to learn more and to hear from Philips representative Dr. Pamela Amelung.
Dr. Amelung is helping St. Luke’s implement Philips eICU Program, an acquisition made possible earlier this year when we were awarded an $11.7 million Innovation Award from the Centers for Medicare and Medicaid Services (CMS).
This “virtual ICU” will benefit critically ill residents of southwestern and central Idaho, eastern Oregon, and northern Nevada who are cared for in St. Luke’s rural, critical access hospitals.
The eICU Program will allow critical care intensivists and other specialists from our tertiary care hospitals to evaluate, treat, stabilize, and monitor patients in conjunction with providers and coordinators on site with the patient. This same technology will aid us in establishing a telestroke program, where neurologists from the tertiary care hospitals can assist emergency center staff at our critical access hospitals evaluate patients to see whether they can be adequately cared for close to home or whether they require transfer for advanced therapies not available in our rural hospitals.
This is very exciting as we transform to deliver integrated, seamless, and patient-centered quality care across all St. Luke’s settings. The technology is certainly transformative; Dr. Amelung told us that other health systems have seen a 22 percent reduction in mortality and a 23 percent reduction in length of stay in connection with use of the eICU Program. We expect to see reduction in ICU mortality rates, reduction in ICU days, increased access to specialty care, and more timely interventions for seriously ill patients.
When physicians and other providers communicate and consult by means of telemedicine, with full access to all patient information including imaging and laboratory studies, we coordinate our care. And in the event that a patient does require transfer, we assure that the care is seamless.
This approach also very patient-centered, in that we will be able to provide much care locally that previously would have required transfer out of the region, resulting in an inconvenience and strain on family members, as well as increased cost. In addition, just as we have found in our other quality initiatives, implementing and standardizing evidence-based medicine across our System leads to significant quality gains and lives saved.
Over the next three years, we expect to train about 110 workers and create two-dozen positions for critical care nurses, health care assistants, information technology support specialists and analysts, clinical educators, and others who will work with our eICU Program.
This is one more step in our journey to accountable care – better health, better care, and lower costs. Our eICU Program should provide better care and help reduce the total cost of care for critically ill patients in the rural areas we serve.
For Dr. Goltry, the eICU Program is an innovative way to relieve bedside clinicians from the constant and necessary practice of “reactionary medicine,” as he put it. The support of colleagues who can analyze data, check records, and consult via cameras, microphones, and computers is too valuable not to make use of, he thinks.
“There’s no reason not to be able to do that,” he said.
David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.