Improving Critical Care: VISICU

Project: Improving Critical Care: VISICU (Project #30)

Partner: University Hospitals and Health System (UMMC)

In an effort to address the lack of critical care access and the shortage of critical care physicians in the Mississippi Delta, the Delta Health Alliance is working with University Hospitals and Health Systems to offer the Improving Critical Care in the Mississippi Delta with VISICU program. The VISICU eICU® program at the University of Mississippi Health Care is also known as Intensiview℠. Designed as a highly advanced critical care patient monitoring system, the VISICU program provides a second layer of attention to critically ill patients, as well as support to their primary ICU care providers.

How Intensiview Works

Given the constant demand on a physician’s time and the increase in numbers and acuity of critical care patients, the need for more robust monitoring and support is evident. The VISICU program provides this monitoring and support 24 hours a day, 7 days a week. Through the use of the latest medical technology, a team of experts in a remote location can observe the condition of critical care patients, and communicate with patients, as well as their bedside physicians and nurses. This is done through the use of two-way audio/video equipment, as well as the interfaced electronic health record. This off-site team continuously monitors and analyzes crucial patient information, such as heart rate, blood pressure, blood test results, medications, and x-rays. This information is sent, scrambled and encrypted, via private data lines, ensuring the upmost security and privacy. As the Intensiview℠ staff provides continuous monitoring and analyzes data, they can alert the primary ICU care providers of any potential problems or conditions, resulting in an increased level of care and support, which leads to improved care for all patients.

Statement of Objectives

Objectives of this project include (1) establish an eICU® Center at University of Mississippi Health Care (UMHC) and successfully operating it within its four critical care units; (2) provide remote monitoring services for critical care patients at critical access hospitals across the Delta; and (3) demonstrate better patient outcomes, increased access to care, provider satisfaction, and cost savings through utilization of VISICU.

Statement of needs to be addressed

Mississippi’s hospitals reflect the issues associated with access-to-care often found in rural areas throughout the country. Of the 97 acute care community hospitals in the state, 28 are critical access hospitals with 25 beds or less. Within the 18-county Mississippi Delta region, there are three counties that have two hospitals; 11 counties with only one hospital; and four counties that have no hospital. These hospitals do not have the ability to support an in-house physician staff that can adequately provide the high level of care required by critically ill patients.

Proposed services

With this proposal, we are joining forces with several critical access hospitals in the Delta to implement an augmented system of care. The goal of this system is to improve patient outcomes and access to care within the Mississippi Delta. This augmented system is a telemedicine program that networks Delta area patients and their bedside physicians with the eICU® monitoring center and provides supplemental monitoring and care by physicians that are Board Certified in Critical Care.

Statement of Major Outcomes: How Intensiview is Working

Based on a severity-adjusted mortality prediction, there were 285 lives saved between 01/01/2010-12/30/2010. Of all the VISICU programs in the country, the Intensiview℠ ranks third in having the lowest actual-to-predicted mortality ratio. Due to timely implementation of all units at UMHC and a valiant effort on the part of VISICU staff, these units are performing better than expected in most measures. To ensure longevity and success of the program, an evaluation team, consisting of clinical and research departments at the University of Mississippi Medical Center and representatives of the Delta Health Alliance, are monitoring the progress of program and evaluating its outcomes.

In 2011, Holmes County Hospital in Lexington, MS, and North Sunflower Medical Center in Ruleville, MS signed up as the first critical access hospitals in the state to receive Intensiview services. Both hospitals are expected to go live with this program by April 2012. In November 2011, Delta Health Alliance was awarded the Delta Health Care Services Grant by the United State Department of Agriculture to expand telemedicine services in the most rural areas of the Delta. Through this grant, four additional hospitals will receive Intensiview services. The proposed hospitals are: Quitman County Hospital, Sharkey-Issaquena Community Hospital, Tallahatchie General Hospital, and the Medical Facility of the Mississippi State Penitentiary. Through a continued commitment and partnership between the Delta Health Alliance, University Hospitals and Health System, and targeted critical access hospitals, we expect to serve thousands of Delta area patients with an eICU Network that not only saves lives, but keeps patients closer to home and their loved ones.