Patients in the intensive care unit need a lot of specialized monitoring, and physician shortages and high costs can create barriers in delivering consistently quality care in hospitals. But implementing a telehealth program can fill these gaps, reduce readmissions and save hospitals millions, says a new report commissioned by the Centers for Medicare and Medicaid Services.
The report, which was conducted by on CMS’s behalf, looked at the implementation of an eICU program at Emory Healthcare. Starting in 2014, the hospital system deployed – which combines audiovisual technology, predictive analytics and advanced reporting capabilities – to five hospitals across Georgia. The system enables 24/7 access to intensivists (critical care specialist physicians) who are in short supply generally and are typically unavailable at nights and weekends.
The eICU program was developed with a goal to expand critical care services in the face of nationwide shortages of these specialized physicians. The program was made possible by a $10.7 million award Emory landed from CMS in 2012, and started with a critical care residency program to train affiliate providers.
Over 15 months, 8,019 patients were cared for by Emory eICU, and more than 60 percent of those patients were federal beneficiaries. According to the report, the telehealth technology saved Emory $4.6 million – or $1,486 in Medicare spending per patient. Savings came in several forms, and were especially pronounced at the two larger hospitals, which served the most severely ill patients and thus had higher care costs. The biggest benefit was the ability for specialists to quickly respond and intervene at dangerous situations during the night rather than waiting for the regular ICU doctors to return in the morning. Additioanally, the eICU platform was credited with bringing problems to the attention of bedside staff that would have otherwise gone undetected.
"Our mission at Emory is to deliver quality care to patients at a cost they and their families can afford and to provide access whenever and wherever people need it,"Dr. Timothy Buchman, director of Emory’s Critical Care Center said in a statement. “These independent findings verify that our innovative approach to addressing a highly variable, complex patient population – those in the critical care unit – improves patient outcomes, allowing them to leave the ICU healthier, thereby reducing the need for patients and their families to have extended rehab stays or be readmitted."
Emory also discharged more patients to home healthcare rather than nursing homes or long-term care hospitals, the report found. Moreover, patients were more satisfied with their care at eICU than those who did not receive treatment with the telehealth platform, and the study also suggests the program improved affiliate provider training and extended the care coverage of each intensivist.
"These findings have shown that increased stability with fewer complications has longitudinal benefits beyond when a patient leaves the ICU," Manu Varma, Philips Wellcentive Hospital to Home’s business leader said in a statement. "As health systems transition to value-based care and depend more on population health tools, these long-term benefits to patients are not only reducing readmissions and improving outcomes, but also have the potential to increase hospital ratings and lower the cost of care."