Phoenix-based Banner Health has been building out its telemedicine program for a decade.
"In terms of our first discussion, we started doing this back in 2004," says Julie Reisetter, CNO of Banner's telemedicine efforts. The telemedicine program officially launched in 2006, with the implementation of Philips' tele-ICU solution, called eICU. Over the past eight years, Banner has rolled out the solution systemwide and is in the process of implementing it at the last site, Fairbanks (Alaska) Memorial Hospital.
The eICU solution employs video cameras with audio hookups in every ICU room to stream a real-time feed to one of Banner Health's offsite monitoring centers. There, tele-intensivists, along with Philips software able to analyze the video feed and flag slight but potentially consequential changes in a patient's condition, closely monitor patients around the clock and alert on-site caregivers to any potential issues.
The Banner tele-ICU system currently covers 430ICU beds across the Banner Health system, supported by remote monitoring centers in Mesa, Ariz.; Denver; Santa Monica, Calif.; and Tel Aviv, Israel.
The tele-ICU system has helped Banner Health significantly improve patient outcomes. The health system determined the telemonitoring saved 34,000 ICU days and close to 2,000 lives in 2013 based on APACHE II predicted length of stay and mortality rates.
These results are consistent with results from other health systems that have used Philips' tele-ICU solution, says Manu Varma, vice president of strategy and business development for Philips Hospital to Home. A recent study involving 32 hospitals using the tele-ICU solution found an average mortality reduction of 26 percent and a 20 percent reduction in average length of stay.
The tele-ICU system is not Banner Health's only telemedicine endeavor. After seeing the positive effects of the tele-ICU in its first few years, in 2010 Banner Health again partnered with Philips to be a beta site for the company's new eAcute care solution.
"It's taking the tele-ICU model and applying it outside the ICU," says Ms. Reisetter. In the two hospitals where the eAcute solution is currently deployed, all patient rooms have cameras sending patient information to remote monitoring facilities. The clinicians at the remote monitoring centers have a general medical-surgical background, not an intensivist background like those on the tele-ICU side, but the monitoring process is the same, says Ms. Reisetter. Early results are encouraging — an in-house study found the monitoring system is especially effective within the first 24 hours of a patient stay, significantly reducing the chances of needing a transfer to the ICU. "We're really excited about this program, and are looking to expand it," says Ms. Reisetter.
Banner Health's newest telemedicine service revolves around at-home monitoring. Using claims data, Banner Health identified some of the health system's highest utilizers and provided the 500 participants currently in the program with many of the traditional home health monitoring tools, including blood pressure cuffs and weight scales. Participants were also given tablets to participate in video consults with caregivers, providing additional support for meeting health goals.
The at-home program, called the Intensive Ambulatory Care program, is only a year old, but Banner has already seen impressive results — early figures project cost savings of at least 40 percent in care costs for the program participants.
Ms. Reisitter says the telemedicine initiatives couldn't have happened without the leadership and support of the health system's executive team. "We're so lucky to have within Banner [Health] the recognition of the value telehealth can bring to patients," she says. To ensure all clinicians and employees at each Banner Health facility are on board as well, the health system hosts open presentations and discussions about the telemedicine project before every implementation. "Anyone can attend — from the nurse in the ICU who will be taking care of the patient to the radiology technician to people in the lab," she says. "We want them to understand what this is and what this isn't, and to get them as excited as we are about the investment Banner [Health] has made."
The presentations make a point of "mythbusting" and assuaging any concerns about the technology, particularly about the video cameras, says Ms. Reisetter. The conversations with frontline staff also continue throughout the implementation process to help incorporate telemedicine into their workflows and examine how it can be best used at each facility.
It's this complete and total engagement with telemedicine that has made Banner Health's initiatives so successful, says Mr. Varma. "They recognized this is an approach that can have an impact across all care settings in a health system," he says. "They're a shining example of how to embrace telehealth."
Banner Health's telemedicine projects will not stop at the three service lines currently used in the health system — officials are looking into bringing telemedicine into the system's skilled nursing facilities and emergency departments. "There's a whole lot [of telemedicine] in the queue," says Ms. Reisetter. "I've got my work cut out for me for months, or really years."
Mr. Varma predicts telemedicine projects will dominate many providers' to-do lists in coming years. "Everyone's going to do it," he says. "It's such a no-brainer, the technology has caught up... bandwidth is improving and you've got the incentives in value-based reimbursement to do it."
"In three to five years, I'd be surprised if a provider didn't have a comprehensive telehealth strategy," he says.
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