The Measure of Telemedicine’s Success: When Families Hug the Monitor
When Dr. Jeff Sadowsky was part of a panel discussion at a telemedicine conference, the question was, “How do you measure the success of telemedicine?” The practitioner who spoke before him articulately addressed decreased mortality, reduced length of stay; all the metrics that show success in the hospital setting.
Dr. Sadowsky had prepared a similar response. But when his time came to speak, he simply told of a recent experience in which a patient’s family member hugged the videoconferencing monitor when he shared the patient’s positive CAT scan results.
“It’s actually happened twice in my practice,” says the medical director of Eagle Telemedicine’s Tele-ICU program. “We have great metrics, too, but nothing for me has ever topped that as the best measure of success.”
RoboCop: Understanding the power of telemedicine
In 2008, when he worked as an intensivist for the Orlando Health network and tried to see how a telemedicine robot could support care in the ICU, he wasn’t sure how to implement it into the hospital’s workflow. “It was one of those high-end robots that clinicians can actually drive around a facility, and we couldn’t figure out how to make it work for us,” he says.
The results were completely different three years later, when Orlando Health asked him to explore how telemedicine could support nocturnal care in the ICUs of two hospitals in the system—Orlando South Seminole and South Lake Hospital. What changed? The way Dr. Sadowsky viewed telemedicine.
“I began thinking about a silly movie I saw a long time ago, ‘RoboCop,’ and it made me aware of the concept of looking at robots differently. I’d been looking at the telemedicine robot to see what it could do, rather than looking to see what I could do with the robot, as an extension of myself.”
Though the robot in “RoboCop” was a far cry from a telemedicine videoconferencing monitor, Dr. Sadowsky applied the movie’s concept to workflow in an ICU, where telemedicine could assist him when doing sign-out with on-the-ground physicians at shift change, could go room to room on rounds as a remote physician and a charge nurse, and could support admission of patients from the Emergency Department (ED). From that point on, he understood and harnessed the power of telemedicine.
The start of a new chapter
“As we added in the workflow, everything fell into place,” he says. “When we saw how easy it was and how much we were able to do, including seeing all the lab results and the records, inputting orders, examining patients and talking with their families, we knew we had a completely comprehensive service that would bring us new success. There is really nothing we can’t do through telemedicine that we can do onsite, including treating ‘code blue’ patients in cardiac arrest. The limitations are minimal.”
Ultimately, a small team of tele-intensivists covered nighttime ICU care at three Orlando Health hospitals at a fraction of the cost of staffing on-premise round-the clock ICU care at the hospitals, with no loss in quality and, in fact, improvements in patient outcomes.
It was the beginning of a new chapter in Dr. Sadowsky’s medical career. He was so impressed with telemedicine as corporate director of critical care at Orlando Health that in 2016, he formed a relationship with Eagle Telemedicine in which he and a team of critical care physicians working from their home offices across the country provide ICU care to a growing number of hospitals partnering with Eagle. ICU care is one of a range of specialties Eagle Telemedicine offers its hospital partners.
“We provide care to small rural hospitals where they might have maybe one or two critical care patients at any given time. These are patients they once had to transfer to other facilities. Now they can keep them where they are closer to their families, thanks to our services. We also provide care in urban facilities that need night service support.”
Benefits for patients, hospitals, physicians
Regardless of the setting or the size of the hospital, Dr. Sadowsky says Eagle’s Tele-ICU team provides a level of care that is usually seen only at a university hospital. “To have an intensivist available 24/7 and to ‘beam in’ twice a day to do rounds on all the patients in the ICU is definitely not the usual standard for a small rural hospital, where critical care patients often have to be transferred to larger hospitals.”
The results speak for themselves. Dr. Sadowsky cites an example of one rural facility that typically cared for up to 20 patients on a ventilator over a two-quarter period. With telemedicine, the number increased to 76 over the next two quarters. “We more than tripled the number of patients they were able to keep because they now have access to our critical care pulmonary services,” he says.
He sees a difference in the telemedicine physicians he works with, too. “They’re all so happy. They can choose their own schedule. They’re professionally satisfied, with exceptional work-life balance.” Dr. Sadowsky’s remote team includes 16 critical care physicians from Arizona, Connecticut, Florida, Louisiana, New Jersey, North Carolina and Texas.
Sadowsky and his wife, Jenn, recently celebrated his 30-year anniversary of graduating from medical school. He says his decision to go into telemedicine, and to work with Eagle, are among the best decisions he’s ever made.
“I love what I do. I love talking with families and helping their loved ones get better. Often, too, it’s helping them work through the death and dying process. And working with Eagle is a great experience. Because the company is led by physicians, our conversations are always physician to physician. We are true partners.”