HIT Thought Leadership Highlight: Dr. Mary Jo Gorman, Advanced ICU
Dr. Mary Jo Gorman established Advanced ICU in 2005 as a solution to the growing ICU crisis across the country — ICU care accounts for a large portion (40 percent) of hospital costs. With only 1.5 ICU physicians per hospital, there is already a shortage in care; which will continue to magnify as Baby Boomers age (those 65+ use the ICU 3 times more than those under 65).
Advanced ICU aims to deliver a solution to this critical issue by working alongside hospital staff to provide 24/7, remote patient monitoring in ICUs across the U.S. The company manages more tele-ICU programs than any other organization in the country, and combines physician-led teams with telemedicine technology to improve the operational, clinical and financial performance of ICUs. For example, after an average of one year of services, Advanced ICU clients see a 40 percent decrease in mortality, and patients spend 25 percent less time in the ICU.
You started out as a medical doctor in the field. What drove you to leave your practice and start your own business? How has your perspective changed since launching the company?
As I practiced in the hospital ? both as an intensivist in the ICU and as a hospitalist — I saw firsthand the importance of having a well-staffed and well-run ICU. In addition, I have been responsible for recruiting physicians and experienced the recruiting challenges that ICUs face. I was aware of some of the technology solutions that were being developed and saw how we could combine our knowledgeable medical team with technology to bring our special expertise to hospitals in need. Now, as I look back, I realize that through the Advanced ICU Care team, I have been able to help more people than I ever could have in private practice. Every week at our staff meetings we highlight a clinical success story, and every month when I look at our clinical outcomes, I know that my training is having a positive impact and helping improve ICU patient care. Since Advanced ICU Care was founded, we have cared for nearly 100,000 patients.
Why is the ICU such a problem in hospitals across the country? What are you doing to address these issues?
The ICU is a significant expense. ICUs usually account for 10 percent of the beds in a hospital, yet they typically generate more than 30 percent or more of the hospital’s costs. In fact, some studies estimate that 40 cents of every dollar a hospital spends is in the ICU.
In addition, ICUs are often undermanaged because of lack of intensivists and their expertise. These operating inefficiencies can lead to long length of stay, high costs and emergency department diversions.
Using telemedicine technology, the Advanced ICU Care team helps relieve the burden of ICU management and supplements a hospital’s existing staff to provide continuous intensivist support. Our 24/7 team collaborates with patients, physicians and nurses, helping enhance patient outcomes and the quality of life for bedside physicians. Additionally, we help decrease ICU costs by providing the analytics and assistance to help drive improved performance.
How will the ICU “crisis” play out in the coming years? How is the “crisis” different now than it was 10 years ago? Why the “crisis?”
Consider the numbers: Every day 10,000 people turn 65 years old and patients over the age of 65 use the ICU three times more than those under 65 years old. As the number of patients in the ICUs increases, it is important to have appropriate staffing. But according to a survey by Leapfrog Group, nearly two-thirds of hospitals do not meet standards for physician staffing in the ICU. The rising need for intensivists and the lack of available physicians is creating two issues: lack of staff and rising cost of staff. The cost of hiring these intensivist specialists continues to rise according to a recent Modern Healthcare survey … last year, intensivists’ compensation increased by 10.3 percent year-over-year from about $296,000 to $327,000. So, as we look at these numbers, the crisis is pretty clear.
We know that hospitals today are under increasing pressure to reduce costs while meeting a growing ICU demand. However, they often lack the information that they need to measure their performance and to drive programs with results. The aging population and the reduction in reimbursement that hospitals are facing were not as critical 10 years ago. Hospitals need to find new ways to address these issues in order to care for their patients.
Why telemedicine? How will this solution help solve some of the issues hospitals are facing in critical care? What about rural health systems? How are they addressing these issues?
Telemedicine offers hospitals access to the same level of care that is available in leading national hospitals. Our program is an easy-to-implement, cost-effective entry into tele-ICU care that reduces transfers, improves patient outcomes and enables patients to stay close to home. Telemedicine solutions can apply to a wide variety of hospital sizes.
How does the Advanced ICU Care tele-ICU program actually work? Why does it fit into the market and why is it a game-changing technology?
With the Advanced ICU Care program, hospitals can implement a 24/7 telemedicine model that partners physicians on the hospital medical staff with the capabilities of intensivist specialists. So how does this all work? The tele-ICU intensivist physicians operate from a centralized location where they continuously monitor patient data, including vital signs, medications, labs, trends in patients’ clinical status and outcomes of care. The intensivists at Advanced ICU Care are assisted by a team of Advanced Practice Providers, Critical Care nurses and a technology team to assure that they can respond to changes in patient conditions, anytime night or day.
At Advanced ICU Care we are addressing an unmet need. There simply are not enough intensivists in this country to staff every ICU 24/7. We offer these hospitals the opportunity to access the expertise they need in a cost-effective way.
This is a game-changing technology because the clinical decision support tools assist the team in identifying urgent problems. The tele-ICU team and the hospitalists can work together to address situations immediately, before complications develop. They are able to collaborate using two-way video and audio that enable face-to-face consultations.
What are the benefits to the patient, bedside physician, critical care nurse, etc.?
The clinical results are excellent. The Advanced ICU Care tele-ICU program has been proven to reduce ICU mortality by 40 percent. In 2013 alone, we cared for more than 27,000 patients and conducted more than 61,000 patient interventions.
The tele-ICU also has a significant impact on physician satisfaction. Because they have an extra set of eyes on their patients, the bedside team is able to better focus on patient care and is more productive. They also receive fewer interruptions during their busy days in the office or the operating room, and fewer calls in the middle of the night allowing them to achieve better work life balance and extending their careers.
For the critical care nurses, they have more confidence knowing that there is an extra layer of support. They also have immediate access to an intensivist specialist 24/7 which gives them the help they need.
Dr. Gorman’s credentials:
• More than 20 years of clinical, healthcare management and entrepreneurial experience
• Prior to founding Advanced ICU Care, she served as the chief medical officer at IPC – The Hospitalist Company, where she developed programs to enhance clinical performance and patient care in hospitals across the U.S.
• She was also the founder and president of Inpatient Care Group, the first hospitalist services company in St. Louis, and Critical Services, Inc., which provides around-the-clock intensivists services at community hospitals.
• Former president and six-year board member of the Society of Hospital Medicine, she was awarded the Master in Hospital Medicine in 2010 for her contributions in that field.
• Named one of the Top 25 Women in Healthcare by Modern Healthcare in 2009
• Selected as one of Ernst & Young’s ten Entrepreneurial Winning Women in the United States in 2011
• Received her M.D. from Southern Illinois University School of Medicine, her M.B.A. from the Olin School of Business, Washington University in St. Louis, and her B.A. in chemistry and biology from St. Louis University