Virtual ICU Brings Specialty Care to More Hospitals

Small and rural hospitals can have a tough time keeping patients. Many will drive an hour or two to the nearest city for all but the most basic — or most urgent — care. And the sickest patients may have to be shipped out anyway, to reach the specialists that might save them.

What if high-tech tools could bring the big-city expertise to their patients instead?

That’s the pitch from Visicu Inc., a 10-year-old company acquired a few months ago by a unit of electronics giantPhilips.

More than a hundred hospitals from the Florida Keys to Hawaii have put some of their ICU patients under the electronic gaze of specialists at bigger, distant facilities a bundle of sensors and software it markets as an eICU. Several facilities say they’re saving money, cutting length of stay, and probably saving lives as well. Today, Visicu said 156 hospitals using its system saw lower mortality rates than average nationally. ICU stays were shorter, too.

Telemedicine isn’t exactly new, but mostly it’s been relegated to long-distance consultations and visual exams by video-conference. Visicu adds to that a bunch of bedside data — pulse, temperature blood-pressure, blood oxygen content, urine output, EKG, lab results and more — piped in real-time to intensive-care specialists, often in another state. Special software helps the remote docs monitor multiple patients.

It’s not cheap: Hays Medical Center, a 168-bed hospital in central Kansas, spends about $600,000 a year to link 12 ICU beds with a bigger hospital in Kansas City, Mo., says CEO John Jeter. That’s 18.6% of Hays’ ICU budget, and neither insurers nor Medicare reimburse for the cost.

At the same time, over the first 18 months Hays used the system, it saw nursing turnover fall — and revenue rise by 15.3%. Jeter attributes at least part of the improvement in both areas to the eICU.

Similarly, Avera Health – a chain of 26 hospitals, many small, spread across big stretches of Iowa, Nebraska, Minnesota and South Dakota — figures it reduced length-of-stay by nearly half, from 4 days to 2.05 and saved millions of dollars in the process.

Still, don’t expect the eICU to replace the real thing — or end medevac flights from remote areas. “This is an augmentation, not a replacement, for bedside services,” said Arthur Klein, chief physician at Lifespan, a five-hospital Rhode Island chain that last fall considered adopting an eICU but postponed a decision pending expansion plans. Among other things, “a physical exam will tell you if the liver or the spleen is enlarged,” he said. “Nothing supplants a physical exam.”

Maryann Kennedy’s just glad the eICU was set up in the 25-bed Avera Marshall Regional Medical Center, in Marshall, Minn., in late 2005 when she started crashing after two surgeries for acute pancreatitis. With her blood-sugar, blood-pressure and heartbeat fluctuated dangerously, doctors once would have sent the 75-year-old retired nurse 90 miles by helicopter to Sioux Falls. Instead she stayed put, a boon to her family, which could visit her while looking after her husband, who had Alzheimer’s disease.

“Everyone said to me afterward, why didn’t you transfer to Sioux Falls,” said Kennedy, who had been a nurse at the same hospital. “I said I didn’t have to go there — they came to me.”