1. Team Members Eric Chavez Sophia Mantovanelli Cheryl Schunk Ashok Tyagi

2. New England Healthcare Institute (2007)

3. Cummings (2007), Kahn (2014)

5. Measurable outcomes Effective & Efficient 24 hour intensivist coverage in an ICU improves patient outcomes as lengths of stay are shortened and mortality is lowered. As these metrics go down, total cost of care is lowered. (Breslow 2004)

6. Equitable and patient- centered Many more patients monitored by a single intensivist team including those in underserved areas. Safe and timely Fewer patients in satellite hospitals that need a risky transfer in order to receive real-time intensivist care. Measurable Outcomes

7. “Research has shown that in ICUs where intensivists manage or co-manage all patients versus low intensity there is a 30% reduction in hospital mortality and a 40% reduction in ICU mortality” from the Leapfrog Group’s safety practice, ICU physician staffing web page.

8. Young (2000), Pronovost (2001), Rosenfeld (2000), Kelly (2004), Knaus (1985), Knaus (1991) Market Assessment

9. Why do we need TeleICU?

10. Projections before and after TeleICU implementation ($/day) BeforeAfter Average ICU daily cost 1,6481,411 Average case cost 10,4447,871 Cases per month 116124 Contribution margin per month 796,2451,321,767 Young (2000), Breslow (2004) Economic Impact

11. Young (2000), Pronovost (2001), Breslow (2004), American Journal Medicine Quality 2007 6 month cost analysis Initial cost $30,000 per ICU bed for equipment

12. ICU physician champion: Ted Armbruster M.D. who has a strong foundation and interest in TeleICU development C-suite strongly in favor Satellite & Flagship Hospital administrators: Overall strongly in favor of TeleICU (reduce overall costs & increase revenue)

13. Project advocates: Improved ICU mortality and LOS Cost savings & sharing, additional revenue Competitive edge over other health systems Staff support at flagship hospital readily available Leapfrog Group initiatives met with intensivist coverage for all

15. Breslow (2004), Philips eICU Program (2014), enVision eICU (2014) TeleICU Architecture Established vendor for delivering TeleICU

17. Legal, ethical, regulatory, credentialing, privacy, and security issues can all be managed by current in-house personnel. Once TeleICU set up and running well, intensivist command center services can be leased to other hospitals = more return on investment.

19. Kumar (2013)