Interview with LOU SILVERMAN, Chairman and CEO, Advanced ICU Care
Lou Silverman has a 20+ year track record of healthcare success across technology, services, pharma, and analytics companies – including publicly traded, private equity backed and venture funded organizations. Across the years, sectors and organizations, common denominators driving success include building companies and teams that thrive on and excel at anticipation, execution, creativity and quality. Since joining Advanced ICU Care, the nation’s largest tele-ICU company, as CEO and Chairman, Silverman has led significant growth, more than doubling the number of hospitals and beds served by the company over his 3+ year tenure.
What strategic initiatives in a hospital can acute care telemedicine help address?
Acute care telemedicine supports a hospital and health system’s primary focus: improving patient outcomes. By leveraging technology-enabled clinical services, telemedicine can positively impact the evolution of facility and care delivery processes and methods in ways proven to enhance clinical outcomes. New initiatives that improve clinical outcomes while generating a positive ROI are doubly beneficial. Using tele-technology to connect patients and existing bedside care teams with expert providers located in alternate locations is a natural step in the ongoing evolution of clinical services. Tele-ICU services are a primary example of an acute care telemedicine application that delivers proven, enhanced clinical outcomes and additionally respects the hospital’s need for delivering care in a financially responsible manner.
Tele-ICU clinical services deliver 24/7 intensivist oversight of ICU patients, which is proven to elevate care quality and lead to documented reductions in many important clinical and outcomes measures – including mortality and Length of Stay. This around-the-clock care by critical care specialists promotes consistent compliance with clinical best-practices. These, in turn, deliver improved patient care outcomes and metrics, including lung-protective ventilation, ventilator LOS and use of blood transfusions. Clinical improvements such as these, in addition to reduced LOS, directly lead to cost efficiencies as well. Critical care telemedicine further contributes to a robust ROI by improving a hospital’s ability to treat higher-acuity patients, leading to an increased Case Mix Index, decreasing physician and nurse turnover and supporting other service lines such as surgery. Finally, increases in case volume directly contribute to increased revenue.
Hospitals can deliver improved clinical outcomes and simultaneously benefit from a positive ROI by employing telemedicine in the acute care setting.
How does a clinical care service such as tele-ICU relate to a hospital’s overall telehealth initiatives?
In addition to supporting improved outcomes and robust ROI, 24 x 7 x 365 tele-ICU initiatives leverage innovative technology and skilled critical care providers to efficiently deliver the right critical care, to the right patient, at the right time. While individual hospitals may prioritize the benefits of the broad range of telemedicine initiatives differently, the basic benefits of an overall telemedicine strategy typically include accessing an expanded pool of limited clinical resources and improving patient access to high quality healthcare. Further, a robust telemedicine strategy enables many hospitals to deliver and sustain a higher level of care than would be possible without tapping the efficiency, scalability and cost efficiency of the telemedicine model.
Tele-ICU is a proven means of delivering on the above principles and, as such, should be foundational in any telemedicine strategy. Because of the limited supply of intensivists and the cost to attract and retain them, most hospitals find it difficult – or even impossible – to fully staff their ICUs with intensivists to the 24 x 7 x 365 “gold standard,” which can lead to a well-documented gap in ICU performance and outcomes. A healthy telemedicine strategy ideally anchors to proven use cases, such as tele-ICU, and subsequently layers on more experimental efforts.
Why are hospitals tempted to overlook clinical services such as tele-ICU in the rush to consumer telehealth?
We believe that consumer telehealth and clinical telemedicine services are two distinct concepts. Therefore, the data points relevant to one concept do not translate to the other. Consumer telehealth is essentially an employee benefits play, with employers and insurers serving as the purchasers of such services for their aggregated patient populations. Utilization is typically measured in non-clinical metrics. Clinical telemedicine, on the other hand, is squarely focused on patient clinical outcomes and refined clinical delivery systems. Hospitals and hospital systems are the purchasers of such services.
Over the past couple of years, there has clearly been more mainstream attention paid to direct-to-consumer telehealth applications, and companies involved in this arena appear to be, in aggregate, delivering convenience to subscribing parties. They are additive to existing delivery systems and exist in parallel with those systems.
While operating in the “quieter” clinical environment, the clinical telemedicine eco-system continues to enjoy outstanding adoption and continued innovation and is increasingly viewed as the standard of care for both today – and tomorrow. Clinically oriented telemedicine programs, such as tele-ICU, integrate into existing clinical organizations and require collaboration and innovation around clinical workflows and communication protocols, with individualized delineation of responsibilities between existing bedside teams and their tele-medicine partners.
Bottom line, we do not view consumer telehealth and clinical telemedicine as an either/or discussion. They are two different services serving two different purposes, with different measures, buyers and benefits to patients. Each is bringing innovation and results to the markets and constituencies they serve. Both are adding material value today and have bright future prospects.
How do patients and their families react to remote ICU care?
The interactions that we have with our patients and their families are overwhelmingly positive. Our team is heartened each day by the testimonials and commendations we receive from patients and their families. There is an increasingly broad realization that we are additive to the attention and care patients receive. The fact that a tele-ICU capability enables many patients to be treated in closer proximity to home and with family present is an additional, highly appreciated benefit.
Because tele-ICU complements the work of bedside providers, more time and more attention can be spent on individual patients – a level of service which patients and their loved ones recognize. The around-the-clock availability of tele-ICU clinicians provides benefits to both patients and bedside teams, often expediting clinical interventions and assisting often harried bedside teams. Enhanced clinical outcomes, shortened lengths of stay and near universal availability of tele-ICU teams to work on both an emergent and ongoing basis benefits patients, their families and, by extension, the hospital.
What trends are driving hospitals and health systems to embrace next generation healthcare IT innovations?
The trends are oft-discussed and well documented. They include the need for enhanced access, improved outcomes, best practices, data-driven care and cost effectiveness. Technology-enabled clinical teams are aligned with each of these important themes.
We can expect continued industry disruption as companies and healthcare providers leverage emerging technologies to both build on existing delivery systems and develop non-traditional delivery methods. Additionally, partnerships with third party innovators will continue, accelerating the reengineering and reorganization of current care delivery mechanisms.
Data collection, analysis and integration will continue to evolve – providing documentation of progress, opportunities for improvement and proof of the overall health of operations – enabling hospitals to adopt innovative care approaches based on actionable insights. In healthcare, technology and data combined with the very necessary human element enable everyone in the healthcare ecosystem to leverage telemedicine to the advantage of all constituents – patients, families and providers.