Healthcare Finance News, January , 2008:
Virtual ICU is cost-effective for rural system
SIOUX FALLS, SD – Using a virtual intensive care unit is enabling a rural healthcare system to provide critical care cost-effectively across several states.
The virtual approach has been shown to help Avera Health hospitals provide better care, and it enables the system to cost-effectively staff multiple facilities.
It’s difficult for rural hospitals to attract specialized caregivers, and the eICU approach helps make best use of key staff members and increases the satisfaction of many staff associated with caregiving to critically ill patients, said David Erickson, MD, senior vice president and chief medical officer of Avera Health, the health ministry of the Benedictine and Presentation Sisters.
The approach fits hand in glove with Avera’s approach, which emphasizes sharing support services to maintain care at more than 230 locations in eastern South Dakota and surrounding states. It operates regional centers in Aberdeen, Mitchell, Sioux Falls and Yankton, S.D. , and Marshall, Minn.
About 70 beds are wired for the eICU in about 15 facilities. More sites for the virtual ICU are in the pipeline.
“We’re geographically challenged,” Erickson said. “Some of our sites are very rural. Recruiting is a problem, and we can’t work these people 24 hours, seven days a week.”
Avera purchased the technology from Baltimore-based VISICU, Inc. in the spring of 2004 and has rolled it out to its critical access hospitals. A study completed in 2006 found that Avera posted a 60 percent improvement in severity-adjusted ICU mortality, when comparing actual vs. predicted rates.
VISICU’s solution enables hospitals to standardize ICU care across multiple hospitals and leverage scarce manpower resources. Intensivists and nurses monitor patients through a high-fidelity telemedicine network, and software helps monitor patient care.
Erickson said Avera’s ICU performance has improved since last year; in the most recent quarter, it treated some 1,000 patients in four core facilities and reported 80 percent fewer deaths than expected.
The virtual ICU also is helping reduce lengths of stay, which helps reduce resource consumption and increases profitability by spreading fixed costs over more patients.
Also, shorter lengths of stay can effectively increase patient capacity at facilities that otherwise wouldn’t have room in their ICUs.
“Our length of stay is down, and when you pair that with the mortality results, I think it makes sense from a financial perspective,” Erickson said. “We feel we’ve improved quality and decreased ventilator days, so even if there weren’t any benefit financially, we feel it’s the right thing to do.”