Issue link: http://viewer.e-digitaledition.com/i/50897
HITEXCHANGEMEDIA.COM Today, telemedicine comes in three forms: Send-and-store, wherein a medical entity sends information (i.e. x-rays, blood work, etc.) to another medical entity digitally. Once sent, the infor- mation is stored for reference at a later time. Since both parties don't have to be present for the exchange to occur, send-and-store isn't considered a simultaneous or "real-time" form of telemedicine. Video conferencing, which has been implemented in health care settings for the past 20 years or so. New mobile technologies such as lap- tops, smartphones and tablet devices have added a level of sophistication previously unknown to this form of telemedicine. Continuous monitoring, which com- bines send-and-store and video con- ferencing for a more comprehensive exchange of health information. As its name suggests, continuous monitor- ing happens around the clock, in real time, using remote visual and data observation to monitor patients. A Ripe Time Enabled by continuous monitoring, tele- medicine is finding a novel use in an unex- pected place: the ICU. "Naturally, the most common applica- tion for remote continuous monitoring is in the acute care setting, where informa- tion exchanges can't be planned ahead of time," says Mary Jo Gorman, MD, MBA, chief executive officer and co-founder of Advanced ICU Care in St. Louis, Mo. "So far, telemedicine is being imple- mented in approximately one in 10 ICUs in the United States, and that number is growing." The demand for ICU services in the United States has risen steadily over the past 30 years. The reason is threefold: 1) The average life expectancy has increased. 2) The baby boomer generation, which makes up more than a quarter of the U.S. population, is getting older. As they age, the geriatric population is expected to grow to twice its current size by 2030, bring- ing a higher demand for critical care and this quality measure will continue to be a growing challenge. Adding to this challenge is the prob- lem of uneven distribution. Of the roughly 10,000 intensivists currently practicing in the U.S., most are con- centrated in larger metropolitan areas, 35 | HIT EXCHANGE Healthcare Business + Technology JANUARY/FEBRUARY 2012 vices against larger, full-service hospitals in nearby cities. For patients, the draw of tele- ICU is the ability to stay close to home. "Hospitals in denser urban areas have the upper hand, because the demand for ICU care is much greater," Dr. Gorman says. "Hospitals in less dense areas can't management of chronic illness. 3) There is a critical shortage of intensivists in the U.S. In 2008, the Leapfrog Group identi- fied key benchmarks for improving quality care in the face of nationwide aging. One recommendation was to increase staffing in ICUs. In fact, the Leapfrog Group estimated that 53,000 lives could be saved each year through better ICU staffing. But with a short- age of intensivists in the U.S., meeting leaving a noticeable deficit in rural and mid-sized communities. "There are simply not enough intensiv- ists to go around," Dr. Gorman says. "This shortage is what's driving the rapid growth of telemedicine." Dr. Gorman, who works through Advanced ICU Care to help set up tele-ICU programs in community hospitals across the country, says these smaller hospitals can use telemedicine to leverage their ser-