Havasu Regional Medical Center, located in Lake Havasu City in Western Arizona, had two problems that are not uncommon to rural medical centers: there was a shortage of critical care trained physicians to work in their Intensive Care Unit (ICU), and due to the lack of neurologists in the area, they were ill-equipped to quickly handle stroke patients without transferring them to a major metropolitan area. What was the answer to their problems? Implementing telemedicine in those two key areas: Tele-ICU Critical Care and Tele-Neurology.
In their Intensive Care Unit, Havasu partnered with Advanced ICU Care, a company that specializes in tele-ICU Critical Care. They provide physicians as well as critical care trained nurses to monitor, watch and consult with Havasu staff to improve outcomes. At the hospital, Havasu purchased and installed high definition cameras, monitors, and communication equipment in each of their 16 ICU rooms. That equipment connects to Advanced ICU where their critical care trained physicians are able to monitor ICU patients, review medical records, input orders, and write notes in the EMR system. Based on this partnership, Havasu has seen reduced costs: per Havasu’s Chief Medical Officer, Dr. Michael Rosen, on average Havasu’s ICU patients spend fewer days in the hospital, less time on life support, and have a decreased mortality rate from sepsis and other illnesses. Havasu’s tele-ICU partnership has helped support ICU evidence-based practice and instituted measurable quality and safety improvements based on national benchmarks. It has also eliminated the transfer cost to a bigger hospital which can run up to $50,000.
In the Emergency Department, Havasu works with SOC Telemed with the help of a computer/monitor/camera on wheels. This equipment can go into any room so the tele-neurologist can see the patient and help the Emergency Department physician assess the situation. Because of telemedicine, Havasu has been able to give the proper thrombolytic medication safely and in a timely manner to help reduce the long-term effects of a stroke instead of transporting to another healthcare center.
While costs have lowered, and positive patient outcomes have increased, Havasu still has one frustration with telemedicine: reimbursement. Currently, Havasu absorbs the costs of telemedicine, as it is often not reimbursed at all, or at the same rate as in-person medicine. Michael Patterson, FACHE, AZ Market President and CEO of Havasu Regional Medical Center, acknowledges the benefits to the patient, but admits that reimbursement “is a barrier.” According to Patterson, “telemedicine should be allowed and should be reimbursed by insurance companies and Medicare/Medicaid at the same rate as those services delivered through an in-person visit. If the quality is the same, the payment should be the same.”