Despite regulatory challenges and relatively small reimbursement for telehealth services, health leaders at the American Hospital Association's annual meeting Monday say the cost savings are significant and urged hospital executives to leverage the power of the technology.
Dignity Health Woodland Memorial Hospital, a 108-bed community medical center in California, originally had one intensivist to cover eight beds in the ICU, so it launched a teleICU component to provide constant intensivist coverage, according to Kevin Vaziri, pictured, president of the organization.
The organization could no longer maintain the status quo, but it was cost-prohibitive to hire four to five additional intensivists to provide full-time coverage. Vaziri estimated it would cost $300,000 to $500,000 a year for just one intensivist salary.
The telehealth initiative was cost effective and an effective solution, he says.
"It was not a replacement, but it was a complement to the local team. We had the power of 16 teleintensivists, so patients had access to an intensivist 24/7 at the bedside," Vaziri says.
Although he was concerned that the new platform could have a negative impact on patient satisfaction, Vaziri says that a year after the go-live date, the hospital's patient satisfaction scores are 91 percent. The program allows patients to receive faster access to an intensivist. The teleintensivists "beam in" and meet with hospital staff for lightning rounds to discuss all cases at 9 a.m. and 9 p.m. The video-audio connection is reliable and the teleintensivists have easy access to images.
The outcomes are also impressive, he says. The hospital has had a 60 percent reduction in mortality rates, a 60 percent reduction in re-intubation, a 40 percent reduction in emergency department transfers and a 10 percent drop in intensive care unit transfers. Furthermore, the hospital doubled the contribution margin per patient.
The traditional intensivist staffing cost the hospital $100,000 per monitored bed per year. The teleICU model costs $30,000 per monitored bed per year.
"As for nurses and hospitalist satisfaction," he says, "they love it."
The program has proven so successful the organization plans to add a telehealth component for cardiology and psychiatry, he says.
Panelists Shez Partovi, M.D., chief health information officer and vice president of informatics at Dignity Health, and Nancy J. Gagliano, M.D., CMO of CVS Health/CVS Minuteclinic, noted during the panel discussion that challenges to telehealth include physician credentialing, differing state licensing regulations, as well as upfront operational costs and low reimbursement for the services.
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