Lisa Lindgren, Director for eEmergency at Avera Health in Sioux Falls, South Dakota discussed Avera Health’s eCARE and eEmergency services at the North Dakota Heath Care Reform Review Committee meeting held in November. Avera Health is a regional partnership of health professionals that share support services to care for patients at 300 locations in eastern South Dakota and surrounding states.
The Avera eCARE suite of telehealth services operates to sustain and improve access to care and services in rural facilities. The impact of Avera eCARE has touched 150,000 patients, serves 165 hospitals and clinics, serves 1,000 providers, covers 495,000 square miles, and has saved $60 million in healthcare costs.
Avera eICU CARE links intensive care units to an around-the-clock care team led by intensivists. Cameras in patient rooms allows the eICU team to closely examine critically ill patients. Decision-support software continuously analyzes patient-specific data and then alerts the team to any changes in a patient’s condition. Avera has observed a drop by 20 percent in mortality rates in patients monitored by the eICU CARE team.
According to Lindgren, eEmergency is an innovative concept linking two-way video equipment in rural emergency rooms to emergency trained physicians at a central hub 24/7. eEmergency provides support to rural clinicians, reduces wait times, reduces unnecessary patient transfers, reduces delays in diagnostics, treatments, and services, and acts as a second medical team.
Since eEmergency was introduced in 2009, as a pilot in eight Critical Access Hospitals (CAH), in eastern South Dakota, the service has seen more than 6,000 patients plus an additional 11,000 patients transfers have been coordinated through the service.
eEmergency has also impacted the delivery of rural cardiac care, Through the eEmergency Chest Pain Initiative, participating hospitals have reduced median time spent in the ECG room from 12 minutes to 8 minutes, median time to thrombolysis by nearly 19 minutes, and door-in door-out time by more than 30 minutes.
Today, the eEmergency system is live with 85 sites, covers over 495,000 square miles, treats more than 9,500 patients, has arranged 11,000 transfers and over 1,150 transfers were avoided, which produced an estimated $9.17 million in transfer settings.
The initial setup for eEmergency is the most expensive and time consuming aspect of the system. Lindgren reports that the monthly fee for eEmergency services is a flat monthly fee based on the hospital’s size, volume, and acuity of care. She pointed out that the hospital’s trauma certification does not recognize that the hospital has access to services through telemedicine that includes eEmergency.
The Chairman of the Health Care Reform Review Committee requested that Avera Health submit additional information regarding any specific North Dakota legislative issues, suggestions, or recommendations on how the state should address the specific issues.