ICU telemedicine programs bring essential critical care to community hospitals

By: Stephen Matchett, MD, CEO for Critical Care

Rural hospitals, though a staple for the communities in which they exist, have long struggled to provide adequate critical care for patients. For many of these hospitals, retaining high-acuity patients is essential for their economic survival, but while they may have appropriate equipment, they lack the clinical expertise specific to the kinds of issues treated in an intensive care unit.  

With larger metropolitan hospitals struggling to manage the limited capacity of ICU beds, timely patient transfer isn’t always an available option, and even when it is an option, patients and their families in the community have an expectation that they can stay local for care. With the absence of intensivists on the ground in these community hospitals, the question becomes how to treat these patients where and when they need care. 

Our answer: tele-critical care. 

Our tele-ICU program, which is part of our critical care specialty, has brought meaningful and much-needed intensive care to remote communities for the past five years. Increasingly a valuable option for rural hospitals, tele-ICU provides access to higher acuity care and support to emergency and hospital medicine clinicians who are called to the ICU. 

Alleviating overwhelm for clinicians and patients

Critically ill patients who are admitted to a community hospital that isn’t resourced for ICU treatment often have to wait for care, and in many of the cases we see, timeliness matters to the outcome. 

Partnering with a telemedicine critical care team alleviates the pressure on both the hospitalist team and the patients. In many cases, patients who receive tele-critical care can stay in the community where they live and have a support network. 

How — and why — it works

Our tele-intensivists are available 24 hours a day to support teams on the ground, working 12-hour shifts to support hospitalist teams as well as emergency department (ED) triage. While we primarily partner with our own Sound specialty teams, we also work independently with employed and other outsourced clinical teams. Sometimes, we work with just one community hospital, but frequently, we provide critical care to patients at several community access hospitals within a health system.   

The work we do includes: 

• Consulting on new admissions, floor transfers, or existing ICU patients 

• Daily ICU multidisciplinary rounds 

• Assisting with in-house code blues 

• Participating in family meetings and discussions around goals for care 

• Completing care documentation and treatment orders in the patient’s electronic medical record 

Community hospitals often see positive improvements through ICU telemedicine, including: 

• Round-the-clock access to critical care support 

• An ability to increase volume and acuity, with continuous ICU support 

• ED triage support  

• Improved patient satisfaction, when patients can receive treatment locally 

• Fewer transfers, which reduces the burden on primary hospitals  

• Fewer ventilator days and a decrease in mortality rate at the community hospitals where tele-ICU is integrated into critical care 

Integrating critical care telemedicine into rural and community hospitals offers numerous benefits both to the clinical teams on the ground and the patients they treat. With time, the partnership between tele-intensivists and hospitalists brings more confidence and allows for more patients — and patients with higher-acuity needs — to receive care locally. That, in turn, keeps patients close to home and loved ones, improving their overall experience and satisfaction with their care and the hospital. 

If you’d like to learn more about how our tele-ICU program can benefit your hospital, contact us here.