What’s On People’s Mind

The SCOTUS ruled effectively to cede control back to the individual states regarding the issue of abortion, by overturning an approximately 50 year old case, Roe v. Wade, which had made abortion a “right” at the federal level. States may outlaw abortion at the state level, or may not. Putting aside completely this contentious issue itself, it is worthwhile for administrators to consider what they personally believe to be a right when it comes to their hospitals’ critically ill patients. Do they have a right to be less likely to die? If that is a right, and they are less likely to die by conforming with the Leapfrog standard, having board certified critical care doctors involved in the patient care equation, to the extent that hospitals do not have boarded intensivists on staff, are they obligated to integrate TeleICU?

As adoption of virtual ICU as a means of providing patients often life-saving critical care became more widespread over the last 20 years, appropriate and relevant standards gained traction. ICU medicine as a medical specialty in the United States requires care provision by physicians who are board certified in the critical care specialty, in order meet the standard of care. Such physicians, variously called intensivists, critical care doctors, intensive care physicians, boarded intensivists, and so on, can provide care via telehealth according to The Leapfrog group. Leapfrog is the de facto standard with which hospital should comply. How do hospital system administrators view the relative importance of conformity with clinical standards in the context of high inflation and interest rate hikes from the fed? Nearly everything is more expensive these days, and the cost of capital is higher, and there is expected to be an economic slowdown. Should capital expenditure decisions made by hospitals for innovative technologies which enhance patient care be tied to national economics when people’s lives depend on it? Today’s blog entry asks more questions than it answers — these are simply difficult questions that must be grappled with.

With leaders like Jamie Dimon, CEO from JPMorgan Chase, saying there’s a economic hurricane looming and we just don’t know if it’s a smaller hurricane or more like a Hurricane Sandy, and Elon Musk indicating he will cut 10% of the Tesla workforce ahead of an expectation of an economic downturn, what does that mean for TeleICU decisions? Hospitals broadly are saying they are under financial pressure so while an argument can be made it’s not an optimal time for them to make capital expenditures, TeleICU need not cost signficant capital expenditure, can save expense, and can actually increase revenue. Time will tell if hospital administrators will use pure financial logic while doing the best for the patient to make their eICU go / no go decisions.

Up >50% in the last 2 weeks. Hospital admissions also up significantly though not as much as new cases. But for admitted patients, will eICU play a signficant role? All signs point to yes, particularly for those hospitals adapting the technology, but even for those that do not, they will undoubtedly transfer out critically ill patients to those that do have access to remote intensivist physicians.

New cases on the rise again in a leading country for Covid vaccine roll-outs. Keeping a watchful eye on it.

What is the state of telemedicine in Ukraine? Send your insights to us.

New Covid cases are on the decline. Will the trend continue?

Sonofi and GSK collaboration says their Covid vax protects as much as 100% against hospitalization. Is it a game changer?

Biden administration quietly decides to focus on hospitalizations and deaths due to Covid-19 (mortality) rather than daily new case count. An effective way to reduce deaths is to provide ICU patients the standard of care, which is management by a board certified critical care doctor via telehealth when there is otherwise no board certified intensivist available for bedside care.