VA Southern Nevada Healthcare System

VASNHS is now offering Tele-ICU services at the North Las Vegas Medical Center

NORTH LAS VEGAS, Nev. – Veterans receiving intensive inpatient care in southern Nevada now access to expanded critical care capabilities thanks to a new telehealth initiative at the North Las Vegas VA Medical Center.

Feb. 26, the VA Southern Nevada Healthcare System went live with a Tele-ICU program in its intensive care unit. Working in partnership with the VA Midwest Health Care Network’s Regional Tele-ICU System in Minneapolis, this new capability provides local medical staff with around-the-clock bedside access to experts who are specially trained in the care of critically ill patients.

“This technology allows us to bring critical care nurses and intensivists to the bedside all across the country at the press of a button,” said Dr. Matthew Goede, associate medical director for the VA Midwest Health Care Network’s Regional Tele-ICU System, and a general surgeon on staff with the VA Nebraska Western Iowa Health Care System in Omaha, Neb. “It allows us to be a second level of support for the doctors and nurses at the bedside.”

With the push of a special “eLert” button, a medical staff member at the North Las Vegas VAMC contacts a Tele-ICU Support Center in Minneapolis. An expert at the Tele-ICU Support Center will then connect into the room via a secure video link and offer assistance, making care recommendations based on a patient’s condition.

“We can access the patients’ records (to include labs and images), monitor vital signs, perform assessments, and provide on-site medical professionals with real-time critical care advice,” said Dr. Robert Bonello, medical director for the Midwest Health Care Network’s Regional Tele-ICU System and doctor of internal medicine at the Minneapolis VA Health Care System. “This allows both ICU teams to make more informed decisions regarding patient care.”

At the North Las Vegas VA Medical Center, 12 rooms are equipped with the Tele-ICU capability. However, as the VA continues to expand telehealth services, the technology could be used in other areas such as emergency departments, step-down units and in acute care rooms in the future. “This really opens up access for our Veterans,” said Shari Kym, VASNHS’ nurse manager for the ICU and Step-down Unit and Remote Telemetry. “As a specialty, ICU medicine is very limited in the number of intensivists, so this really provides a way for our ICU and Step-Down Veterans to have access to that type of specialty medicine.”

Filling critical care specialty positions is a struggle nationwide, and the VA and State of Nevada are not exceptions as the state currently ranks 47th nationally for physicians per capita and 48th for nurses. “Intensivists and experienced ICU nurses are at a premium across the country,” said Goede. “Studies show that there is a shortage in many of those specialties. What Tele-ICU allows us to do is amplify the care that these intensivists can provide over without having to physically be in every location. It allows for a second opinion, it allows for a second set of eyes, and it provides a good adjunct to the care they are already getting bedside.”

Nearly one in five VA ICU beds are equipped with Tele-ICU technology with the capability currently at 28 facilities in 15 states. In the future, the capability will expand to 40 medical centers in 25 states. The VA also recently launched a partnership to provide Tele-ICU support to the Department of Defense, with Nellis Air Force Base, Nev., becoming the first DoD facility with the technology. “This program started as a critical care collaborative just between VISN 23,” Goede said. “But as more and more sites began to get wind of it, we expanded it from there.”

To meet its expansion goals, Bonello said VISN 23 has opened a new Tele-ICU sub-hub in conjunction with the activation of our virtual support program at the VA Southern Nevada Healthcare System. “This will allow VA intensivists to provide care to 20 additional VA medical centers around the country,” he said.

“I think this is the future of medicine,” Goede concluded. “It’s really popular in critical care, but I think we will see it in other fields. In general, it’s been exceptionally well-received by staff and by Veterans. It’s been a very effective tool when it comes to critical care.”

As for Kym, she feels the partnership with VISN 23 Tele-ICU team will pay dividends in increasing the quality of patient care locally. “We now have additional support that is available 24 hours a day, 365 days a year and their presence will help us in improving our acuities so that we can care for more complex patients. I can’t ask for anything better.”

“We’re excited to begin this partnership with the Minneapolis VA and have this added expertise available to our staff and Veteran patients,” said Dr. Ramu Komanduri, VASNHS chief of staff. “By expanding our VA capabilities with a semi-virtual presence such as Tele-ICU, we are able to ensure our Veterans have direct access to the same level of care and services, regardless of where they live.”