The impact of a surging baby boomer population on the ICU

The statistics on the sheer size of the Baby Boomer cohort and the stresses that it will generationally place on numerous disparate eco-systems are easy to find.

For a summary refresher, consider that nearly seven Baby Boomers turn 65 every minute – a rate of 10,000 every single day1 – and that it is projected that this particular demographic will account for 20 percent of the U.S. population by 2030 2.

To anticipate the significant healthcare implications of this well-known phenomenon, consider the connected trends: a) an increasing percentage of low-to-mid acuity healthcare is delivered outside the four walls of hospitals; b) extended life expectancy means larger numbers of older, sicker people; and c) the age 65+ cohort is a well-documented heavy user of critical care services. It is a legitimate conclusion, not original to this article, that an increasing percentage of hospital beds will be “repurposed” to serve as ICU beds. In this case, demand begets supply.

The brick-and-mortar piece of this equation is analytically straightforward. Certainly, there are budgetary consequences and other logistical implications of such a development but getting from A to B is quite linear. Less linear, and in fact insolvable without a change in the status quo, is the provider model required to serve this population. Today, and therefore certainly tomorrow, there are simply not enough intensivists (critical care specialist MDs) to deliver the quantity and quality of ICU patient care that has been well-documented to deliver superior outcomes for ICU patients. In fact, the National Center for Health Workforce Analysis projected an 11% reduction in the supply of critical care medicine physicians between the years 2010 and 2025. We are more than half way through that time period, and the accuracy of the prediction has held. We cannot meet this growing need without a material change in the way we leverage the expertise of providers to deliver care to critically ill patients.

Over the past decade, the ways people book travel, make investments, communicate with family, conduct research and pursue recreational and entertainment opportunities have changed dramatically. There have been some parallel changes in healthcare, but the pace and magnitude of transformation has been more muted than in many other sectors. Tele-ICU partnerships have and will continue to address the present and growing provider gap and have provably delivered improved outcomes to patients, families and hospitals. Such partnerships complement the care provided by bedside staff and consistently improve outcomes, while delivering these enhanced outcomes in a manner that brings documented ROI to participating hospitals as an important, albeit secondary, benefit. By integrating experienced critical care teams, technology, reporting and best practices derived from working with leading hospitals and hospital systems – and by impacting hundreds of thousands of patients and families each year – tele-ICU has proven to be a solution that creates a win for all constituents in the process: patients, families, bedside teams and hospitals.

For the uninitiated, tele-ICU unites experienced critical care physicians, advanced practice providers, nurses and data specialists into care teams working at an off-site care center. These teams access and leverage real-time patient information and a two-way A/V communications infrastructure to deliver patient care and guidance, much as they would if they were physically at the bedside. The tele-ICU solution is laser-focused by using purpose-built technology backbones, real-time data flows and dedicated care teams working remotely, but licensed in each state and credentialed onto the medical staff at each hospital, and integrating seamlessly with bedside care teams and into hospital workflows. Tele-ICU is solving known problems in a directed manner and achieving everyone’s goal of ensuring that patients in need receive enlightened and appropriate care 24 x 7 x 365.

Baby Boomers have been part of an ongoing evolution to drive continuous improvement. After all, this is the generation that framed every challenge with the preface: “If we can send a man to the moon…” In healthcare, this has come to mean an expectation of accessing the highest quality care in times of need. The expectation is clear. It is present. And at some point in time for everyone, it ceases to be a third-party problem. We (and our peers) are focused on delivering and improving care, not debating or downsizing care. We are able to deliver what’s expected and do so in a manner that is budget friendly for our partner hospitals while creating the type of win-win environment that enables acceptance and sustainability of change.

To date, Baby Boomers have chosen to provide their parents and loved ones with the best available care and have now also come to expect that same level of care for themselves. Those patients and families working with ICUs that employ tele-ICU solutions typically find comfort, reassurance and confidence in the care they receive and the idea that their loved one is receiving the “gold standard of care.” The choice between care in a busy ICU staffed with talented local, bedside clinicians or a busy ICU whose team of talented local bedside clinicians is augmented by additional, dedicated critical care specialists who work in tandem with the bedside teams, leverage state-of the-art communications technology and clinical algorithms, and who are on duty and available at all times of the day or night regardless of emergencies elsewhere in the ICU is increasingly obvious. This choice is logical, as the benefits of 24/7 tele-ICU care have consistently been proven -- in both objective, academic third-party studies as well as in actual practice -- to save lives, reduce length of stay in the ICU and the hospital and improve quality outcomes.

The strain on national, local and hospital healthcare resources will persist as more Americans join the growing list of boomers-turned-seniors. The inexorable march of history and innovation leaves most hospitals and healthcare with a clear choice – to sustain yesterday’s care model, downsized to meet today’s budget, or to adopt a more progressive care model that leverages the best of both bedside care delivery and technology-enabled clinical expertise. Similarly, the growing population of ICU patient boomers – and their families and the hospitals that they use – have an increasingly unusual opportunity to access enhanced ICU clinical attention and outcomes in a way that respects the financial realities of the surging boomer population and the need to constantly ensure that care delivery is focused on clinical outcomes – and provides an ROI benefit to the hospital as well.

1 D’vera Cohn and Paul Taylor. Baby Boomers Approach 65 – Glumly, Pew Research Center, 2010.
2 Sandra L. Colby and Jennifer M. Ortman. The Baby Boom Cohort in the United States: 2012 to 2060, United States Census Bureau, 2014.

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