Healthcare Executive - September/October 2013 - 52

Satisfying Your Customers

The two-way video monitoring allows
the intensivist to “camera in” whenever
the situation dictates. An “eICU” button—located on the wall, next to the
patient bed, inside each critical care
patient’s room—summons an awake,
alert intensivist at 3 a.m., eliminating
the tradition of paging a physician, who
some minutes later returns the call.
Surrounded by a bank of monitors,
intensivists staffing the eICU have
everything at their disposal to achieve
outstanding clinical results. In addition
to visualizing the patient, other information made available through the
eICU includes medications, drips, IV
fluids, ventilator settings, vital signs,
allergies and past medical history.
The attenuation, definition and resolution of the video monitoring allow the
intensivist to visualize the patient and
are sufficient to assess skin color and
pupillary response. Because the video
capability is two-way (the intensivist
appears on a dedicated monitor), meaningful interaction and dialogue is possible between the intensivist and patients
and their families. I have even witnessed
sincere end-of-life discussions being
conducted via this technology. During
the four years we have had eICU monitoring, there has only been one complaint about the physician being remote.

After further education with the family
about how the ICU team works cohesively, this matter was resolved.
Two hospitalists are in house 24/7 to
provide care at the bedside after
hours if it is needed. They evaluate
all admissions and interview patients
and families. Anesthesia is also in
house to provide airway management. The organization’s nocturnist
hospitalists have been trained to
insert central lines.
An Unmatched ROI
From the beginning, open communication with patients and our community and awareness about the
new eICU was a priority. As a part
of this, patients and families were
educated about the HpRH ICU
team approach. Communicating to
patients and families about the constant vigil and patient safety
enhancements provided by the eICU
brought patients and their loved
ones a sense of security and comfort.
Overall, feedback from our patients
and the community has been positive.
patients and families feel reassured by
the constant monitoring, and they
express amazement about the use of
technology. We have also received

Benefits of an Electronic ICU
In 2009, High Point (N.C.) Regional Hospital, part of High Point (N.C.) Regional
Health System, began providing remote electronic monitoring of critically ill
patients in its ICU. Since implementation of the eICU, the organization has noted
several benefits to its patients, including:
• Continuous 24-hour monitoring of patients, which contributes
to a more proactive plan of care
• Improved patient safety
• Shorter patient stays
• Patients’ own doctors direct their care

Healthcare Executive
SEpT/OCT 2013

positive feedback from staff members,
who are another key customer base of
the eICU. Immediately when the
eICU went live in 2009, we heard several positive comments from HpRH
staff, including: “this is great for
patient care”; “please don’t ever take
this away”; “if the eICU is ever taken
away, I will leave”; and “I would never
work anywhere without an eICU.”
We pay our eICU vendor a rate of
approximately $800 per case. In
2005, it cost $28,000 to take care
of a ventilator patient at HpRH.
Today, that cost is approximately
$18,500. Nearly $9,000 per case is
being saved with an $800 investment, and every conceivable quality
metric has improved, saving lives
and reducing adverse events such as
ventilator-associated pneumonia.
That is an ROI I would challenge
anyone to match.
There simply aren’t enough intensivists available nationally to provide
24/7 coverage. By working with a
collaborative vendor that uses
HpRH’s care protocols, quality of
care has improved, costs have
decreased and patient satisfaction
has improved.
For our organization, the eICU represents a smart, resourceful solution
to a national conundrum. In our
experience it is the perfect marriage
of technology and process improvement to maximize clinical expertise
for the greater good of patient care
across the United States. s
Greg Taylor, MD, FACHE, FACPE, is
senior vice president/COO of High Point
(N.C.) Regional Health System. He can
be reached at GTaylor@hprhs.com.

Healthcare Executive - September/October 2013

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