MERCED — Added steps have been taken at Mercy Medical Center to improve care of critically ill patients through collaboration with a St. Louis medical group.
Mercy Medical Center started using the services of Missouri-based Advanced ICU Care three weeks ago in a pilot program unique in California.
Through telemetry and television hookups, patients in Mercy's Intensive Care Unit can be monitored around the clock by a team of critical care specialists thousands of miles away.
Dr. Rob Streeter, Mercy's vice president of medical affairs, said the partnership with Advanced ICU Care has added a layer of coverage. Sometimes patients' conditions change rapidly and an intensivist, a doctor specializing in emergency medicine, is needed urgently at a patient's bedside.
But it may be 3 a.m. and the doctor is home. Through the linkup with Advanced ICU Care, decisions can be made immediately to treat that patient's symptoms, Streeter said.
On the first night the service went live, the remote doctors detected a patient's breathing tube had developed a leak and needed to be replaced. The problem would have been discovered eventually, but it was remedied before the situation became critical, according to Streeter.
It's a simple supply-and-demand issue, with limited availability of intensivists and this is a way to bring added expertise to local ICU care, Streeter said.
Dr. Isabelle Kopec of St. Louis is one of the founders of the service and vice president of medical affairs for Advanced ICU Care. She has been an intensivist for 20 years and said the telemedicine system devised in 2005 supplements a hospital's critical care team at a patient's bedside.
By TV linkup, Kopec said her company is in very close collaboration with local doctors. The Advanced ICU Care team has access to the same patient medical information and telemetry, including X-rays and laboratory reports, as Merced critical care nurses and doctors.
"Patients benefit from two critical care teams," Kopec said. "Our role is to supplement the critical care team bedside. We're here 24-7 to address new issues and deliver the right care at the right time. We all look at the same information."
Robert McLaughlin, Mercy's marketing director, said the first-year operating cost and installation of the system totaled $750,000; the hospital has 20 ICU beds and typically serves 350 to 400 critical care patients a month. There is no added cost to the patient for the new service.
Dr. Sunit Patel of Merced is the hospital's medical director for the ICU. He spends about eight to 10 hours a day at the hospital and another seven hours at his medical office.
Patel, who is chairman of the hospital's ICU committee, said the ideal is there should be an intensivist at the hospital 24 hours a day, but that's not cost-effective.
"This is the next best thing to support local care," Patel said. "It gives me some comfort level knowing things are handled."
Also pleased with the added collaboration is Sal Dowhaniak, lead registered nurse. He said within two or three minutes the hospital can establish full contact with the remote ICU team.
"Things change in an instant," Dowhaniak said. "They can talk to local physicians and send progress notes. They are hands-on with all vitals and can make a decision right on the spot. It's a nice feeling having other physicians on hand."
McLaughlin praised the team approach and said it's better for the patient. "It works well when we work closely together," Kopec said. "It's gratifying to see the impact we can have."
Kopec and other doctors have had the idea for a telemedicine system for years but had to wait until modern technology made development of the necessary software possible.
The ICU partnership can have an outstanding impact on patients' outcomes. Kopec said the telemedicine partnership can result in a 40 percent drop in mortality and a 25 percent reduction in the length of patients' stays.
Mercy is the only hospital in the 39 Dignity Health System facilities in California, Nevada and Arizona piloting Advanced ICU Care. The system has been in the planning stage for almost a year, McLaughlin said. Advanced ICU Care serves 30 hospitals in 14 states.
Kopec said people are living longer, and as the population ages, the need for ICU care grows. Patients over the age of 65 are three times more likely to need critical care.
The high-definition roving camera in the central monitoring station can pick up the sounds and images of everyone in the ICU. The company also has monitoring stations in New York City and India.
"All patients will benefit," Patel said, "and this will reduce the length of stay in the ICU."
Patients get better quicker because their stay in the ICU won't be as long, Streeter said.
Reporter Doane Yawger can be reached at (209) 385-2407 or firstname.lastname@example.org.