NM hospital uses video conferencing in ICU

November 28, 2011 • State News

In this Wednesday November 23, 2011, photo, Isabelle Kopec director of the Advance ICU of St. Louis is seen through a TV monitor in a patient’s room at Presbyterian Rust Medical Center in Rio Rancho, N.M. [auth] The new electronic tools lets medical staff observe by video camera and monitor a patient’s vital signs from St. Louis. (AP Photo/The Albuquerque Journal, Dean Hanson)

RIO RANCHO, N.M. (AP) — If you ever find yourself in the intensive care unit at Presbyterian Rust Medical Center in Rio Rancho, don’t be surprised to see Dr. Francis Ntimba’s face appear on a TV monitor in your room, live from St. Louis.

Ntimba can observe you by video camera and talk with the medical staff in real time. Electronic tools allow him to monitor your vital signs.

He also has access to X-ray and lab test results and can read medical notes logged by your attending physician in Rio Rancho.

Welcome to the world of “tele-ICU,” which allows critical care specialists to treat patients remotely with the help of video conferencing and other tools.

The service is intended primarily for smaller hospitals, few of which can afford to staff their ICUs round-the-clock with “intensivists,” said Dr. Denise A. Gonzales, medical director of the Rust Medical Center. Intensivists are physicians who specialize in critical care medicine.

Tele-ICU features two-way audio-visual patient monitoring from a central command center staffed by doctors and nurses who specialize in critical care medicine.

“We have access to everything an on-site physician has,” said Ntimba, an intesivist and one of 20 physicians employed by Advance ICU Care of St. Louis, which offers medical services to about 20 hospitals nationwide. Presbyterian Rust Medical Center is the first New Mexico hospital to use tele-ICU, hospital officials said.

“When it was first presented to me . I was skeptical about how this could be done,” said Gonzales, who is also an intensivist at Presbyterian Hospital in Albuquerque. “Now that I’ve experienced it, I think it’s a very workable model.”

If tele-ICU proves useful at Rust Medical Center, Presbyterian will consider offering the service at its other regional hospitals in Española, Tucumcari, Socorro and Ruidoso, she said.

ICUs care for a hospital’s sickest patients, who require continuous monitoring and treatment. The 68-bed Rust Medical Center has six ICU beds. An intensivist staffs the unit five hours a day, from 8 a.m. to 1 p.m.

Each patient also has an attending physician called a hospitalist, who specializes in hospital medicine.

As soon as a patient is admitted to the ICU, the staff in St. Louis have access to virtually all the patient’s vital signs, lab results, medical history and records, said Dr. Isabelle Kopec, vice president of medical affairs for Advance ICU Care.

Physicians in St. Louis can monitor patients remotely and alert the medical staff in Rio Rancho if a patient’s condition worsens. Computer programs can detect trends in a patient’s condition that might not be apparent to the medical staff on site.

“A lot of times, we may pick up that the patient really is starting to deteriorate,” Kopec said. “The beauty is that we are an extension of the critical care team that is already at the bedside. We all see the same information.”

And staff physicians on site can perform procedures under the direction of intensivists in St. Louis.

Rust Medical Center pays Advanced ICU Care a flat fee of $800 per patient. Patients are not billed directly for the service.

Hospitals nationally have been slow to adopt the technology since the first tele-ICU “command center” was installed in 2000, according to a report issued last year by the Massachusetts Technology Collaborative and the New England Healthcare Institute.

In 2010, 41 tele-ICU command centers served 249 hospitals nationwide and monitored about 5,800 ICU beds, or about 7 percent of the total, the report found.

Costs, unproven return on investment and resistance from local clinicians, who may fear being displaced or second-guessed by remote physicians, have slowed the spread of such services, the report said.

“I think there’s a lot less resistance now from physicians,” Kopec said. “Now, we are actually seeing physicians and physician groups asking for support. They see this as something that will help them be more efficient.”

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