- Housed in a warehouse separate from the rest of the health system, Intermountain Healthcare’s tele-critical care program may very well prove that some of the best healthcare takes place away from the patient.
The program, launched in 2014, connects more than 200 intensive care unit beds around the 22-hospital network to a team of doctors and nurses trained to “offer proactive and reactive support” to clinicians at the bedside, no matter where that bed is. And when there’s another set of eyes and ears focusing solely on the data, outcomes are bound to improve.
“One of our explicit aims … is that we want to meet critical illness and injury when and where It occurs,” says William Beninati, MD, medical director for critical care telehealth at the Salt Lake City-based health system, one of the largest and most telehealth-enabled in the country. “We want to create a bubble of critical care” around the patient.
Intermountain created its tele-critical care program from scratch, relying on guidance from some of the top telehealth minds in the country but shying away from commercial platforms because, Beninati says, they wanted something that fit their needs and goals.
Locating in a warehouse means the staff of 22 doctors and 20 nurses is separated from the day-to-day activities of the health system, allowing them to focus on the patients and the care teams around them. That’s especially important given that the platform reaches out into smaller hospitals and clinics and rural communities, where resources are thin.
In fact, it was one of those smaller community hospitals, asking for help in 2011 to support a new intensive care unit, that set Intermountain on the path to launching the tele-critical care program.
“It’s not exactly rocket science,” says Beninati. “It’s simple bread-and-butter things that need to be done to stabilize (the patient), then continue that support.”
The program has produced results. In the past year and a half, Intermountain has seen mortality rates drop by one-third in its ICU units, as well as among its community hospitals. While pointing out that the results (and the million-dollar savings) can’t be attributed solely to the telehealth program, Beninati says the program has enabled more complex-care patients to transition out of the ICU and back to their home communities.
“That’s very important to us,” he says. Aside from reducing the number of days spent in the hospital (and the extensive costs associated with ICU care), this enables patients to continue their care at home with their primary care physicians and family.
The tele-critical care program also serves another purpose, one not often mentioned when talking about the benefits of telehealth. For critical care patients who won’t recover from their illnesses, the platform gives clinicians a chance to work with the patient and caregivers at home, and perhaps help them to stay at home rather than spend the rest of their days in a hospital.
“There’s a human benefit,” says Beninati.
He expects the platform to evolve alongside the health system, branching out to help more patients and their care teams in acute care environments- such as working with rapid response teams in Code Blue situations. He also expects the platform to integrate more predictive analytics capabilities, with an eye toward identifying critical situations before they occur. And he’d like to see a “smart alerting” system put into place, combining multiple alarms, parameters and other data sources to help caregivers improve their care patterns.
All of this, Beninati says, is leading Intermountain toward what he calls the health system’s “bread and butter” – providing healthcare and care management services that have less to do with the hospital and more to do with the community.