Tele-Echocardiography: “The Right
Thing to Do” for ICU Patients
By J a n e Er i ck s o n o n
June 18, 2015
I
n 2006, Banner Health made the
decision to equip every one of their ICU
beds with an eICU system that provides
round-the-clock, “remote” care to critical
care patients. Banner Telehealth’s eICU
operations centers, located in Mesa, Ariz.,
Denver, Colo., Santa Monica, Calif., and
Tel Aviv, Israel, has helped reduce patient
mortality and shortened ICU stays.
“We’re performing, on average, between
25 and 40 of these procedures per month,”
he says. “It’s a very, very useful tool in
assessing critically ill patients, particularly
when you’re trying to answer the question
‘Why is this patient in shock?’
In 2013, Banner took another step
toward state-of-the-art intensive care, by
implementing a tele-echocardiography
system to relay patients’ echocardiographic
images to the eICU in real time. This was
achieved by training respiratory therapists
to obtain the images and project them in
real time to the tele-ICU physician via the
tele-ICU Camera.
Point-of-care echocardiography is
becoming standard of care in modern
ICUs across the country,
because its utility has been
well documented in the
“This is the right thing
literature. While Banner
has not yet generated
to do. We’ve always held
publications on the efficacy
fast to the belief that our
of tele-echocardiography,
Banner has anecdotal
tele-ICU providers are as
evidence to demonstrate
capable of taking care of
its effectiveness.
“At the bedside, point-of-care
echocardiography is used as an extension
of the physical exam. For us physicians
working behind the camera, it’s like we can
reach through the camera and examine
the patient. We’re very excited about it,”
says Nidhi Nikhanj, MD, assistant medical
director of Banner Telehealth Services.
“What we wanted to do was demonstrate
that we can apply this powerful bedside
tool in a tele-ICU platform.
Banner Health’s teleechocardiography system
“Banner’s addition of tele-echocardiography to its eICU service is an outstanding
example of a successful telemedicine
service implementation in an organization
focused on being ‘best-of-breed’ with respect to its telemedicine innovations,” says
Ronald S. Weinstein, MD, founding director
of the Arizona Telemedicine Program.
“The services Banner is providing are
invaluable.”
The development of this teleechocardiography initiative started as a
small pilot at two Banner hospitals, but is
now being used at nine hospitals across
Arizona, Dr. Nikhanj says.
“This allows us to obtain a diagnosis more
quickly, and initiate therapy in a more
timely manner.”
our patients as our bedside
“A few months ago, one of
my colleagues was called
providers.”
because a patient was
decompensating in the
Nidhi Nikhanj, MD
cardiac unit,” Dr. Nikhanj
Assistant Medical Director of Banner
says. “My colleague was
Telehealth Services
able to diagnose the
patient as having cardiac
tamponade. He contacted
the cardiac surgeon on call to come in the
middle of the night and take the patient
for surgical drainage of the effusion. The
patient did very well.”
Tele-echocardiography also was able to
quickly identify signs consistent with a
pulmonary embolism in another patient
with cardiopulmonary compromise. That
patient also had a good outcome, Dr.
Nikhanj says.
“It’s too difficult at this point to say
whether this is generating a cost-savings,”
he says. “But this is simply the right thing
to do.”
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