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With the help of telehealth technologies, Emory Healthcare in Atlanta saved an estimated $4.6 million in a 15-month period, increased its discharge rate by 4.9% and reduced the rate of inpatient readmissions by 2.1% by using Philips' eICU technology.
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Abt Associates Inc., a research firm in Cambridge, Mass., reported these findings following an audit of Philips' eICU technology on behalf of CMS.
Philips' eICU technology includes audio and video technology, data analytics, and it interfaces with Emory's electronic health records (EHR).
Timothy Buchman, M.D., director of the Critical Care Center at Emory Healthcare, explained that they were facing several challenges that eICU ultimately helped them solve.
The first issue was not having enough staff to deliver the care needed by an increasing number of patients.
"Critical care is a challenging discipline," Buchman said. "It's hard work. People get sick 24/7. People who go into critical care have to work 24/7. And the fact of the matter is that we have a ... widening gap between the number of caregivers who are available and the number of patients who want care."
The second, Buchman said, is Emory Healthcare is made up of many facilities throughout the Atlanta metropolitan area, and "the challenge is trying to figure out how to take scarce critical care personnel and deploy them most effectively," he said.
And the third challenge is EHRs don't provide the necessary population-level health data, Buchman said.
Telehealth technologies to the rescue
For Emory Healthcare, telehealth technologies helped them fill in the gaps. Those gaps were mainly patients' lack of access to care during off-hours -- for example, weekends and holidays.
Buchman explained that on weekends and during holidays, the senior physicians usually go home and a less experienced group of physicians is left in charge. But with eICU, an experienced ICU intensivist physician is sitting in the eICU command center, available for whatever help is needed at any time. Furthermore, patients in the ICU are able to connect with a physician whenever they need or want to simply by pressing a button at their bedside.
"We imagined that during normal business hours, it would be business as usual in the brick-and-mortar ICUs," Buchman explained. "But we wanted to add a safety layer onto that. So, 24 by seven by 365, we have teams of experienced critical care nurses who are functioning, in a sense, as air traffic control. They are sitting using the eICU system and its advanced alerting algorithms to identify patients who are drifting off trajectory."
The technologies at play
More than one technology makes it possible for Emory Healthcare to achieve such results with eICU.
"You've got audio-video connections to the bedside from a command-center-type location, what we call the telehealth center," said Manu Varma, vice president and general manager of Philips Wellcentive and Hospital to Home.
He added, "What makes this really powerful is that we have the analytic and the software workflows, which sit on top of existing healthcare IT landscape," he said. "This is not an EMR replacement or anything like that; it's really an aggregation layer, an agnostic aggregation layer that sits on top of the EMR and healthcare IT that's typically deployed at the bedside."
Timothy BuchmanM.D., director of the Critical Care Center at Emory Healthcare
This allows that central team of intensivists and nurses to watch over patients in the most efficient way possible, Varma said.
Buchman added that eICU also provides alerts and breaks down the data in a way that allows physicians to drill down into any given patient's data. "Not only on who the patient is," he said, "but what the trends have been in the patient's physiology and also the care that's been given."
Buchman said this system has been designed in a way that allows physicians to be successful at "situation awareness."
"And by situation awareness, I mean three things: It allows us to perceive the data, it allows us to comprehend the data, and it allows us to project the data into the future to imagine where the patient might be if we don't intervene and if we make various choices about interventions," he said.
Buchman said these results -- better outcomes, a better experience of care and lower costs -- "that's actually a transformational event for telehealth."
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