Staffing An Intensive Care Unit From Miles Away Has Advantages
MELISSA BLOCK, HOST:
Imagine being in a hospital bed with your nurse or doctor checking in on you from miles away. That's happening in remote hospitals in rural areas - a way of bringing in the expertise of a major medical center. As Michael Tomsic of member station WFAE reports, the practice may also be keeping rural hospitals open and saving jobs.
MICHAEL TOMSIC, BYLINE: Recovering pneumonia is a different experience in the 10-bed ICU in rural Lincolnton, N.C.
(SOUNDBITE OF BELL)
RICHARD GILBERT: Hey.
CASSIE GREGOR: How are you doing, Sir?
GILBERT: I'm doing pretty good today. I'm feeling a lot better.
TOMSIC: Nurse Cassie Gregor's face appears on a screen. She's checking on patient Richard Gilbert through a camera from 45 miles away near Charlotte.
GREGOR: Is there anything I can do for you?
TOMSIC: Gregor wears a headset and sits in front of six computer screens. She's in a generic medical office building, but from there, Carolinas HealthCare System monitors ICUs in 10 of its hospitals. Compared to how ICUs normally sound...
(SOUNDBITE OF HOSPITAL COMMOTION)
TOMSIC: ...The command center is oddly quiet. Dr. Scott Lindblom says it's a nice change of pace.
SCOTT LINDBLOM: There's not any bells or whistles or nothing going off. I mean, it makes it a much more pleasant environment actually to work in than what we're used to - the usual chaos of the ICU.
TOMSIC: The command center is staffed 24/7 with a rotating crew of nurses and doctors who specialize in critical care. Everyone on the team also does bedside shifts. Nurse Qiana Gadson says working in the virtual ICU has its perks.
QIANA GADSON: There's things that I'm able to view here - there are trends that I'm able to view here that I'm not able to view at the bedside that sometimes I wish was available to me.
TOMSIC: Nurse Kimberly Purtill agrees.
KIMBERLY PURTILL: We might see a trend up with their white blood cells, a trend up with their temperature and their blood pressure going down.
TOMSIC: All warning signs of an infection.
PURTILL: If you were off yesterday as a bedside nurse and you're on today, you don't have the picture from yesterday, but we have it in front of us on our screen.
TOMSIC: And it's easy to give the bedside staff a heads-up. Lindblom, who oversees critical care throughout Carolina's HealthCare System, says the virtual ICU is good for patients.
LINDBLOM: We're taking care of more patients than we were two years ago. And across the system, our mortality rate's dropping, and across the system, our length of stay is dropping. It's almost the perfect storm of good care.
TOMSIC: Lindblom says virtual care is saving money, too. This has been true for one system in the Midwest. Avera Health estimates its virtual ICU has saved $70 million over the past 10 years. From one hub in South Dakota, Avera Health specialists monitor patients as far away as Minnesota and Wyoming.
DEANNA LARSON: So I think we quit calculating miles a while back because it's a very vast area.
TOMSIC: That's Avera's head of e-health, Deanna Larson. She says the savings come from reducing mortality, complications and length of stay. Before virtual care, complex patients were often transferred to major medical centers. Now Larson says some of those patients can stay closer to home, and that's good for the local economy.
LARSON: Keeping 10-12 patients more maybe means another nursing job that stays local, maybe means another lab tech job. What the technology is really doing is keeping those economics closer to home and helping them maintain viability.
TOMSIC: Back in Lincolnton, Dr. Jessica Fox says her ICU has been much busier thanks to the remote help.
JESSICA FOX: The unit went from basically having, you know, a couple patients and closing all the time because we were having to transfer so many patients to now being almost full all the time because we're able to keep patients here.
TOMSIC: From his ICU bed, lifelong farmer Richard Gilbert says the more eyes on him the better.
GILBERT: That's the whole idea of farming. If I got a five-man job and I go out there with two people, you might miss something. But if you got all your whole crew, you don't miss anything. You get it done.
TOMSIC: For NPR News, I'm Michael Tomsic.
BLOCK: This story is part of a reporting partnership of NPR, WFAE and Kaiser Health News. Transcript provided by NPR, Copyright NPR.