In medicine, there are always new frontiers—new viruses to conquer, new treatment approaches to manage, new technologies to incorporate in practice.
At Eagle, we are finding the same holds true for telemedicine. We find new uses for it every day.
With the increasing physician shortage, particularly in specialty areas such as critical care, cardiology and nephrology, telemedicine is delivering valuable support to the clinical care programs at many U.S. hospitals. And now, with the growth of long-term acute care hospitals (LTACHs), telemedicine offers an effective model for bringing periodic specialized physician care to LTACH patients, while solving night coverage challenges.
During the eight years since we began our telemedicine initiative, Eagle has established programs providing telehospitalist services and a range of telemedicine specialties in acute care hospitals across the United States. We entered the LTACH market recently, and are currently providing telemedicine night coverage to three LTACH facilities in North Carolina: Select Specialty Hospitals in Durham, Greensboro, and Winston-Salem. The facilities are part of Select’s network of more than 100 long-term acute care sites across the United States.
Telemedicine and LTACHs: A natural fit
An estimated 10-20 percent of hospital patients with critical illness require prolonged medical care after acute care hospitalization. They might be on a ventilator or have other needs like ongoing dialysis or wound care that require more specialized physician care than a skilled nursing facility (SNF) provides. LTACHs have grown significantly over the last 25 years in response to a growing patient population. Some are free-standing facilities; others occupy wings or sections of acute care hospitals.
Unlike many SNF or palliative care patients, LTACH patients typically do have hope of recovery. They require a plan of care and physician attention to help them improve during their extended stay. This is the key element that makes LTACHs unique entities in the healthcare system, with requirements for focused involvement by specialists for extended periods. Because of this unique profile, LTACHs are an ideal environment for telemedicine coverage.
How telemedicine can work for LTACHs
Here are a few examples of telemedicine’s potential in the LTACH setting.
- Economies of scale. One telemedicine primary care physician or hospitalist can typically cover rounding requirements for five LTACHs with a total of 100 beds among them.
- Specialists when needed. Depending on the patient mix at an LTACH on any given day, telemedicine specialists in cardiology, nephrology, neurology and pulmonary care can be immediately available.
- Night coverage. With a telemedicine team providing comprehensive coverage of night calls, code management and admission, an LTACH can let its physicians recharge and revitalize, knowing their patients are in good hands at night.
- Pre-emptive rounding. Other than routine daily rounds, physicians are also needed at an LTACH to do pre-emptive rounding—that is, rounding to spot any declines by patients to prevent a crash or a code blue. This is another task that telemedicine physicians can regularly perform.
Rapid response is key
Through telemedicine, a physician can generally be interacting with a patient within two minutes of receiving a call or text message for assistance. This rapid response is another reason telemedicine is in demand today, and why our telemedicine program has seen such exponential growth over the past year—among acute care hospitals and now through new inroads in the LTACH market.
At Eagle, we are proud to be well positioned—with both the technology and the physician resources across many specialties—to meet this growing demand.