UMass Memorial Health is the largest health system in Central Massachusetts and a clinical partner of the UMass Chan School of Medicine. UMass Memorial is the only Level I Adult Trauma Center and Neonatal ICU in Central Massachusetts.
Experienced caregivers of the health system include specialists in behavioral health, oncology, cardiology, children and women, heart and vascular care, neurology, pulmonology, and surgery.
PROBLEM
For years, UMass Memorial Health has leveraged technology as a means to enhance bedside care. Launched in 2006, its tele-ICU program remotely monitors more than 150 adult intensive care beds across Central Massachusetts.
With the experience gained and the quality results proven, the health system decided to adopt a similar approach in lower-level healthcare settings that still required direct, relevant observation. continue at-risk patients.
“Like many other healthcare systems, the need to control operating costs while improving patient safety is a challenge for our leadership team,” said David Smith, vice president of operations. virtual medicine manager at UMass Memorial Health said. “The concept of a ‘virtual caregiver’ program has repeatedly been cited as a way to reduce the need for inefficient and costly one-on-one patient observation while maintaining our commitment to patient care. patient safety.
“But we struggled to find a reasonable solution at the scale that met our needs at the time,” he continued. “It wasn’t until the arrival of COVID-19 that we realized how effective it was to deliver high-quality virtual care to the bedside without the sophistication and complexity of an ICU program. from far away.”
This, he added, forced them to decide to develop a remote viewing technology that could provide the same level of care as an in-person babysitter, but with a much higher return on investment.
SUGGESTIONS
UMass Memorial chose Caregility as its video integration provider to revamp the medical system’s fleet of aging ICU cameras. That effort was well underway as COVID-19 hit.
“Suddenly we were faced with the urgent need to limit our exposure to a deadly virus that we did not fully understand,” Smith said. “Telehealth is quickly becoming a prominent means of contact prevention in our inpatient facilities.
“With everyone scrambling for mobile video solutions, Caregility took the challenge and equipped us with one hundred of their new APS250 mobile telemedicine trolleys,” he continued. “The trolleys were immediately deployed in all of our COVID units and field hospitals.”
“Remote monitoring has proven to be an effective strategy to enhance care at the bedside or at home.”
David Smith, UMass Memorial Health
As the surge subsided, the health system began to look for innovative ways to capitalize on the rapid expansion of telehealth and repurpose those investments. With hospitals still requiring full PPE, this is a timely opportunity to reintroduce the concept of virtual observation.
Incidentally, Caregility has provided a cost-effective solution within their iObserver platform, Smith notes. “iObserver allows the remote care team to monitor up to 12 patients per screen, with two-way audio/video support, night vision, and responsive bedside alerts.
He continued: “In September 2020, the IT team partnered with nursing leadership and Caregility to launch a virtual observational trial to demonstrate its effectiveness. “Saving labor costs, staff efficiency and patient safety are the main focus.”
MARKET
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MEET CHALLENGES ONLY
Unlike many other telemedicine platforms, iObserver is designed for the sole purpose of observing patients remotely.
“That means the features and functionality one would expect inherent in the user interface,” explains Smith. “The system can work as a stand-alone, so no integration is required to get it up and running. And the ability to retrofit our existing Caregility vehicles with an infrared sensor for night vision has made it a reality. into an ideal solution that can scale quickly.
He continued: “For the pilot, we started with a hybrid hub and spoke model by attaching the telemetry center to one of our sighting units. “This provides local coverage in the event of a technology glitch, and it allows us to optimize system performance and workflows in real time.”
Staff initially started with a three-to-one patient ratio and gradually increased it to six to one, eventually having six more patients followed up as backup for another virtual babysitter.
Smith reports: “Within a few months, the pilot program was deemed a success and the program was rolled out at three hospital facilities. “In the same year, we expanded our team to accommodate the growing number of remote observations, and we are now planning a state-of-the-art ‘digital hub’ to accommodate virtual carer programs and some others such as tele-ICU.
“With over 50 live observations on any given day, our goal is to maximize our workforce through the use of remote patient monitoring,” he added.
RESULT
With some initial skepticism, the nursing informatics team and nursing leadership worked together with IT and Caregility to deliver a new model of care for UMass Memorial that promotes efficiency, savings, says Smith. cost and safety for the patient. It is now embedded in the standard of care that patients expect and deserve, he added, and the health system continues to seek additional growth opportunities.
“One such opportunity is addressing staffing needs at our community hospitals,” he explains. “Given the national labor shortage in the healthcare sector, it is vital that we use our limited resources in the most efficient and cost-effective way possible.
“Remote patient monitoring enables centralized management of large patient groups with far fewer resources than is required for one-on-one, direct observation,” he continued. “Like our telemedicine ICU results, we’ve shown that virtual sitting is just as effective as face-to-face care.”
In its first year of operation, the remote team recorded more than 100,000 interventions through the iObserver system. This includes direct patient involvement through the use of two-way audio or audio/video interactions and alerting the bedside team of potential adverse events such as getting out of bed, cord pulling. and agitation.
This allows staff to maintain patient safety while reducing labor costs.
“Perhaps the best measure of success is how dependent our clinical teams are on the system’s performance and reliability,” Smith commented. “And Caregility is a great partner in that regard.”
TIPS FOR OTHER PEOPLE
Smith advises: “Remote monitoring has been shown to be an effective strategy to enhance care in bed or at home. “Similarly, a virtual babysitter program can enhance the quality of care while reducing staffing needs and labor costs. For many years our challenge was to find a solution that would work. can meet daily needs – but scale for the future – at an affordable price we can justify.
He continued: “In the UMass Memorial experience, success requires a willingness to collaborate with a vendor that has listened to our feedback and offered solutions in the form of improvements and fixes.” “No technology has no limitations or points of failure, so it’s important to have safeguards in place.”
Start small and scale up, he advises – encouraging advocacy among nursing teams and giving them a strong voice. He concluded: “Marketing benefits patients, continuously measuring and sharing results with stakeholders.
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