Advanced ICU Care
Advanced ICU Care is a medical service company that provides high-quality remote critical care to patients in the intensive care units (ICU) of community hospitals.
Situation
Despite studies showing that care by intensivists (physicians specially trained in critical care medicine) improves the quality of care in the ICU, just one in five ICUs is staffed with intensivists.
Either at the bedside or through telemedicine technology, care by intensivists greatly improves patient care. One study found that high-intensity ICU physician staffing (in which all care is directed by intensivists or mandatory intensivist consultation) was associated with lower hospital and ICU mortality rates (in 94 and 93% of the studies, respectively) and reduced hospital and ICU length of stay. Another study showed that care by intensivists using telemedicine technology resulted in a 27% plunge in severity-adjusted hospital mortality for ICU patients, a 17% drop in ICU length of stay and a 13% decline in overall hospital length of stay.
The Leapfrog Group, a consortium of Fortune 500 employers that promotes the quality and safety of healthcare, has identified intensivist staffing as one of its "safety standards." According to Leapfrog, more than 54,000 ICU deaths could be avoided if this standard were implemented.
With just around 6,000 intensivists in the U.S., these specialized physicians are in high demand. By 2010, demand for intensivists is expected to outstrip supply, and this shortfall will continue to worsen given the aging U.S. population, growing to 22% in 2020 and 35% by 2030. Others estimate that the shortfall will be even greater given the increased utilization of intensivists in response to evidence of improved patient care. A 2006 report to Congress showed that demand could be 129% above the current supply by 2020 if the proportion of ICU patients cared for by intensivists were to rise to more optimal levels. Given these supply and demand characteristics, many hospitals - particularly those in more rural communities - are finding it difficult to recruit intensivists for their ICUs.
Solution
Advanced ICU Care® is a medical services company founded to improve access to critical care expertise, deliver best practices to patients by leveraging telemedicine technology and establish intensivists as the standard of care. The Advanced ICU Care program includes three crucial components: cutting-edge telemedicine technology; experienced, board-certified intensivists and critical care nurses; and a process improvement program. Through talented clinicians, supported by cutting-edge telemedicine technology, Advanced ICU Care provides continuous ICU patient monitoring and improved patient care and safety outcomes to acute care hospitals.
The telemedicine technology employed by Advanced ICU Care was developed by VISICU to help address the intensivist shortage and improve patient care and safety in the ICU. This technology combines clinical management software with patient data and real-time video feeds, enabling hospital intensivists to care for and continuously monitor ICU patients from a centralized eICU center.
Using high-speed connections, community hospital ICUs are connected with Advanced ICU Care's eICU Operations Center. The center is staffed by experienced intensivists and critical care nurses who work in collaboration with the hospital's clinical staff to care for and continuously monitor critically ill patients, hundreds of miles away. By delivering board-certified intensivists, Advanced ICU Care's program also offers a solution for many hospitals who may find it difficult to recruit in-house intensivists to provide appropriate coverage in the ICU.
Better Health & Lower Cost
The Advanced ICU Care program optimizes the level of care for critically ill patients while reducing the hospital's costs through reduced ICU costs and lengths of stay, decreased nursing turnover and increased capacity, among others.
In the first year of using Advanced ICU Care's eICU program, St. Mary's Health Center in Jefferson City, Missouri documented a:
- 69% plunge in cardiac arrests
- 24% reduction in ICU patient mortality
- 6% shorter ICU length of stay
- 14% drop in overall hospital length of stay
- 67% decrease in ICU nurse turnover
These outcomes, including substantial improvements in patient care and safety results, lead to lower costs for all insurance payers and patients.
1 Journal of the American Medical Association, 2002;288:2151-2162
2 Journal of Critical Care Medicine,2004;32:31-38
3 Journal of the American Medical Association, 2000;284:2762-2770
4 U.S. Department of Health and Human Services Health Resources and Services Administration Report to Congress
