OffSiteCare’s remote telemedicine consultation and patient care model helps rural ICUs offer top care services.

Intensive care is one of the hospital’s most complex and expensive medical systems. More than 4 million patients are admitted to ICUs each year in the US. Approximately 500,000 patients die in ICUs each year . Mortality rates in patients admitted to the ICU average 10% - 20% in most hospitals1. It is estimated that while patients in ICUs occupy between 5% - 10% of inpatient beds in hospitals throughout the US, the expense associated with these beds is 20% - 35% of total hospital costs1. Further, an average ICU patient experiences 1.7 errors/day and 1 in 5 patients may sustain a serious adverse event during their hospitalization in a critical care unit1.

Attention has now shifted to improving patient safety, delivery of quality care, reducing medical errors and reducing health care costs – these issues typically get top billing among most hospital boards. They are also issues that have many hospitals reassessing how they deliver care among their sickest patients – those in ICU.

There are 25 evidence based protocols and order sets which are available by requesting them at offsitecare@gmail.com For Example, our Sepsis Protocol uses Central Venous Pressures to direct the therapy of shock with a mean blood pressure less than 60mmHg to the use of Normal Saline if the CVP is = or < 12 mmHg and to the use of Dopamine, Norepinephrine, or Vasopression in this ascending order if the CVP is >12. If the central venous saturation is < 70% with the patient intubated on 100% oxygen with an hematocrit > 25%, Dobutamine is titrated for a Central Venous Oxygen Saturation > 70%. These protocols bring the latest in proven interventions to the bedside.

The LeapFrog Group has called for full-time intensivist staffing as a way to save as many as 50,000 lives per year. However, it is estimated that there are fewer than 6000 actively practicing intensivists in the US today and only 13% of ICU patients receive dedicated intensivist care. The demand for critical care and ICU services is projected to rise substantially over the next few decades as the American population ages . Four times as many full-time intensivists are currently needed to provide around- the-clock staffing for the more than 7000 ICUs nationwide. Not all hospitals are succeeding at recruiting intensivists. A shortage of these specialists presents a major obstacle to the adoption of ICU intensivist staffing, especially in smaller facilities.

Critical Care Challenge

Meeting the needs of critically ill patients in small and medium size rural and community hospitals is a big challenge. Smaller hospitals often:

  • Lack economic resources of urban medical centers that can afford multiple specialty consultants and procedures
  • Have a shortage of nurses and medical specialists including intensivists
  • Have a difficult time retaining and training staff
  • Do not have capital to install and upgrade expensive bedside monitoring systems


    • A Novel & Revolutionizing Solution

    In light of the intensivist shortage, many hospitals are turning to telemedicine as an alternative solution. Remote Presence Robotics is an emerging new technology aimed at reducing costs, sharing physicians in a time of shortage and enabling remote monitoring of patients. This technology uses robots to enable remote physicians to literally ‘be’ at the patient bedside and proactively respond to patient care needs just as they would do if they were physically in the hospital. This novel technology is the unique basis for OffSiteCare’s remote specialist driven critical care program that is helping northern California rural community hospitals deliver top quality care services to patients in a timely and cost effective manner. Thus, this trailblazing new technology is preventing these rural and small ICU's and hospitals from becoming endangered species.

    OFFSITECARE CLINICAL MODEL

    OffSiteCare currently contracts with 4 rural northern California hospitals to offer two different service delivery models based on Remote Presence care. It has installed InTouch Health’s robots in the ICU's of these 4 hospitals. For more details, see table below:

    Hospital PALM DRIVE HOSPITAL HEALDSBURG DISTRICT HOSPITAL HOWARD MEMORIAL HOSPITAL UKIAH VALLEY MEDICAL CENTER
    Location Sebastopol, CA
    25 miles west of Santa Rosa, CA     		Healdsburg, CA
    20 miles north of Santa Rosa, CA     		Willits, CA
    100 miles north of Santa Rosa, CA     		Ukiah, CA
    100 miles north of Santa Rosa, CA
    Beds / ICU 37 Total / 5 in ICU 37 Total / 5 in ICU 43 Total / 4 in ICU 78 Total / 6 in ICU
    ICU status ICU was closed, reopened in July 2007 ICU was closed, officially reopened in Jan. 2008
    OffSiteCare Service Model Onsite intensivist 8hrs / day/ 5 days a week
    24/7 remote intensivist on call via Robot
    Hospital bills for onsite intensivist’s consults and procedures     		Onsite intensivist 8hrs / day/ 5 days a week
    24/7 remote intensivist on call via Robot
    Hospital bills for onsite intensivist’s consults and procedures     		Remote intensivist coverage 24/7 - 100% via Robot Remote intensivist coverage 24/7 - 100% via Robot