Virtual ICU Model Plays Key Role in AHN Pandemic Response Planning

Partnership with Mercy Virtual Increases ICU Capacity at Four Network Hospitals 

Increasing critical care capacity has been a central priority of hospitals and health systems that are responding to or preparing for possible surges of patients experiencing the worst effects of COVID-19. In both Pittsburgh and Erie, Allegheny Health Network (AHN) is taking advantage of an innovative critical care telehealth solution developed by St. Louis-based Mercy Virtual to meet this pressing need.   

Following progressive implementation over the last year of Mercy Virtual’s ‘vICU’ capabilities at AHN’s Jefferson, Allegheny Valley and Canonsburg hospitals, the Network last week also launched the program at Saint Vincent Hospital. The partnership has expanded AHN’s ICU capacity by more than 60 beds overall, with the potential to increase capacity by 50 additional beds if needed.   

A subsidiary of the St. Louis-based health system Mercy, Mercy Virtual is a nationally recognized leader in the development and delivery of telehealth solutions to hospitals around the country.

Through state-of-the-art telecommunication and remote patient monitoring technology located in each ICU room at these four AHN hospitals, board-certified intensivists based at Mercy’s Virtual Care Center seamlessly interact and collaborate with AHN clinical staff to provide an additional layer of 24/7 ICU patient care support.

Patient vital signs are continuously monitored by Mercy Virtual clinicians via secure, encrypted connections, while the program’s two-way, high-definition cameras are only activated during patient observations by the Mercy Virtual clinicians and during their engagement with the onsite clinical teams.    

The model uses real-time audio and video that connects to a team of medical professionals in a remote telehealth center. Remote staff can communicate with the hospital staff who are treating patients at the bedside to give guidance for care. The remote team has access to vital signs and electronic medical records to help to best inform onsite staff.  

According to Anil Singh, MD, MPH, MMM, FCCP, Executive Medical Director of Clinical Transformation at Highmark Health and System Division Director of Critical Care at AHN, the partnership with Mercy Virtual has taken on new meaning in the setting of a pandemic as hospitals work to harness every resource at their disposal to care for critically-ill patients. 

“Our collaboration with Mercy Virtual has strengthened the quality and scope of critical care services that we provide at our community hospitals, enabling many more of our patients to receive the advanced care they need closer to home,” said Dr. Singh. “Today, this partnership has even greater significance as we scale operations across our network in response to the COVID-19 pandemic.” 

In caring for those with COVID-19, Dr. Singh says the continuous stream of real-time patient data enables more informed decision making which ultimately enhances the safety of frontline caregivers. If staffing needs should increase, the supplemental care provided via vICU ensures the same levels of high-quality critical care.  

As AHN prepares for possible surges of patients with COVID-19 who require hospitalization in the weeks and months ahead, he says that plans are underway to create even more ICU beds at Allegheny Valley, Jefferson and Saint Vincent hospitals using the telehealth model. 

“The success of our efforts in virtual care is directly linked to forward-thinking partners like Allegheny Health Network and Highmark Health. Together, we are able to constantly challenge the status quo in order to provide patients with the highest quality care. AHN’s patients are fortunate to have such strong leaders who are actively changing the approach to health care, while maintaining their focus on them,” said Ashok Palagiri, MD, Vice President of Mercy Virtual Inpatient Services.

In addition to critical care telehealth, AHN has significantly expanded its use of telemedicine across all components of its primary and specialty care programs in an effort to continue providing patients with safe, high-quality care amid the pandemic. 

AHN is currently facilitating more than 3,000 telemedicine visits each day. Patients can request a virtual care appointment using AHN’s patient portal known as MyChart

What does this mean for healthcare staff? 

It is important to note that the role of virtual care is to enhance the care provided by doctors and nurses at patient bedsides, not replace them. 

The state-of-the-art technology that is used in the virtual intensive care unit model helps to take the pressure off of physical intensive care unit nurses who have been left overworked and overstretched thanks to the COVID-19 pandemic. Many nurses who work in ICU across the globe have struggled to give their critically ill patients the same level of care that would have been given before the pandemic. This is due to the sheer volume of patients who need their care. Subsequently, nurse-to-patient ratios have been dangerously out of balance with staff having too many patients to look after than what is recommended. 

This imbalance has meant that many nurses have felt unable to provide patients with the high levels of care they deserve. The virtual ICU technology allows staff to monitor multiple patients across different locations. Remote nurses can monitor multiple patients at once from their location and then give feedback to onsite staff and alert them of any emergencies that need to be addressed.  

As well as taking the pressure off of staff who are working at the bedside of patients, this telemedicine development has widened the career options for experienced registered nurses. Nurses who work in telemedicine to provide this valuable service and relief to bedside healthcare staff have to adapt to office-based working. This is because they are no longer on the frontline of delivering patient care and instead work in a support role as an expansion of the bedside team. These remote nurses care for patients virtually via camera and keep track of a patient’s vital signs through remote patient monitoring. This provides an additional layer of care that can help to improve patient safety and outcomes by being an extension of the in-hospital team. 

Click here to find out more about pursuing a career in nursing. While telemedicine can help relieve the pressure on healthcare professionals, it does not help to address the current nursing shortage that the COVID-19 pandemic has worsened. 

What does this mean for patients? 

Care received via remote patient monitoring can improve patients’ level of care when in an intensive care unit. As mentioned above, it allows healthcare teams to monitor numerous patients efficiently, which means that the quality of care that patients receive can be improved by implementing a virtual intensive care unit model. 

In the age of COVID-19, these virtual programs can also make patients safer and reduce their risk of contracting viruses while in hospital. Having nurses who can monitor patients remotely in addition to the frontline staff can help to minimize the risk of infection. It also reduces the volume of personal protective equipment that needs to be worn by staff during each shift. 

As well as reducing the risk of COVID-19 infection, patients who are isolated and critically ill with the virus have the option to be kept company by remote nurses, which is crucial to promoting the emotional wellbeing of patients during a traumatic period. With visiting severely restricted, virtual nurses can provide comfort to patients. 

This form of telemedicine also opens up critical care to patients who otherwise might not have easy access to such care due to them living in rural areas and only having access to hospitals that provide limited care options. It can boost the critical care options in such places while also providing support to overstretched larger hospitals found in big towns and cities

About Allegheny Health Network

Allegheny Health Network (AHN.org), a Highmark Health company, is an integrated healthcare delivery system serving the greater Western Pennsylvania region.  The Network is composed of 12 hospitals, ambulatory surgery centers, Health + Wellness Pavilions, an employed physician organization, home and community-based health services, a research institute, and a group purchasing organization. The Network provides patients with access to a complete spectrum of advanced medical services, including nationally recognized programs for primary and emergency care, trauma care, cardiovascular disease, organ transplantation, cancer care, orthopedic surgery, neurology and neurosurgery, women’s health, diabetes, autoimmune disease and more.  AHN employs approximately 21,000 people, has more than 2,500 physicians on its medical staff and serves as a clinical campus for Drexel University College of Medicine, Temple University School of Medicine, and the Lake Erie College of Osteopathic Medicine. 

About Mercy Virtual

Mercy Virtual delivers virtual care services to 600,000 patients across six states, improving patient outcomes and access, while reducing total cost of care. Often called a “hospital without beds,” Mercy Virtual Care Center operates 24 hours a day and is staffed with more than 300 clinicians. Mercy, named one of the top five large U.S. health systems from 2016 to 2019 by IBM Watson Health, serves millions annually. Mercy includes more than 40 acute care, managed and specialty (heart, children’s, orthopedic and rehab) hospitals, 900 physician practices and outpatient facilities, 45,000 co-workers and 2,400 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas. In addition, Mercy’s IT division, Mercy Technology Services, supply chain organization, ROI, and Mercy Virtual commercially serve providers and patients in more than 20 states coast to coast.