Disruptive Women welcomes nationally recognized Intensive Care Specialist Dr. Brian Rosenfeld, as our March 2010 Man of the Month.

Dr. Rosenfeld is an Intensive Care Specialist (intensivist) who pioneered and developed the concept of remote intensive care unit management. He co-founded VISICU Inc. in 1998 with his partner Michael Breslow and served as its Executive Vice-President and Chief Medical Officer. The company had a successful IPO in 2006 and then was acquired by Royal Philips Electronics in 2008. He is currently responsible for devising the strategic direction of tele-health within Philips Patient Monitoring and Informatics.  Prior to founding VISICU, Dr. Rosenfeld was an Associate Professor of Anesthesiology and Critical Care Medicine, Medicine and Surgery at the Johns Hopkins University School of Medicine.  While at Hopkins, he was Director of two critical care units and received the Shannon Award from the National Institutes of Health.

Disruptive Women’s Robin Strongin recently had the opportunity to talk with Dr. Rosenfeld.  A few minutes into their conversation, says Robin, one thing becomes very clear:  Dr. Rosenfeld’s absolute passion for real-time, proactive, quality patient care.  In other words, telehealth—the technology behind Philips-VISICU.

As a cofounder of VISICU, What triggered the idea?

The idea was the easy part.  Developing a company was the hard part.  Before we started what was essentially a software company, I was an attending physician at Johns Hopkins Hospital.  Ironically, I almost had my privileges removed by my ICU colleagues because I initially refused to use the new EMR (electronic medical record) that had just been installed in the surgical ICU.  In the end, though, I recognized the power of information technology as it relates to patient care, high quality patient care.

My epiphany came as I realized that the current trajectory of baby boomers, and their need for ICU level care, was quickly overwhelming an already tenuous system.  ICUs account for 50% of all hospital deaths and approximately 30% of hospital costs; and many of them do not even have an intensivist involved in care delivery. There simply weren’t enough intensivists to meet the needs of this growing demographic group.

But there was a solution:  by utilizing technology and redesigned workflow to leverage the knowledge of intensivists in a way that reached exponentially greater numbers of patients.  By installing two-way audio/video connections and providing the appropriate information technology necessary to remotely monitor and intervene on patients, these highly trained physicians and critical care nurses could be on hand to provide care to many more patients in multiple sites across any geography. Virtually. Approximately 10% of all adult ICU beds in the United States are now monitored and managed with this technology.

What are the benefits of remote monitoring as you see them?

By allowing computer intelligence to scan thousands of data elements on each patient and run these data through proprietary algorithms the system guides the intensivist and the entire health team to work smarter, not harder.  Think about it.  Nurses and physicians who are at the patient’s bedside, are not replaced by the remote critical care team, but have an additional set of eyes monitoring the vital signs, laboratory data, and changes even when the on site health professionals cannot be in the patient’s room.  Studies have shown that properly using this technology can significantly reduce mortality and length of stay, which translates into human and financial savings.

Before remote monitoring was available, nurses, particularly on the night shift who identified a problem with a patient, would literally have to track down a physician or their covering partner and wait to get a call back.  That was Stone Age medicine.  Today, we have physicians monitoring patients around-the-clock.  They can be in touch with the bedside health team in real-time.  Look, the ICU is a chaotic place 24 hours a day 7 days a week.  By harnessing the expertise of these intensivists (of which, by the way, there are only about 6500 in active practice across the country), many more patients benefit as do the on-site staff.

Are there other benefits for the hospital or health system investing in remote monitoring?

Actually, the community itself benefits.  Here’s what I mean.  In the Washington DC metro area, the INOVA health system has set up our remote eICU monitoring program that is staffed with INOVA intensivists and critical care nurses.  During a recent disaster planning exercise that took place across northern Virginia, the eICU Center, which is co-located with the Northern VA Disaster team headquarters was an integral component of that effort.  While INOVA made the investment, the entire community benefits.

I have to ask.  What impact do you expect to see from the recent health reform legislation?

Much of that remains to be seen.  That being said, I can tell you that the Obama administration has embraced tele-health and health information technology in an enormous way.  It is clear to me that the administration understands that you cannot keep adding people to the current system and not change the process of care.  What we are doing is a major step toward an improved health care delivery system for critically ill patients.

We are very pleased with the progress Philips-VISICU has made but recognize that we, and the country, have much more work ahead of us to cure our health system’s woes.

This entry was posted on Friday, March 26th, 2010 at 10:33 am and is filed under Man of the Month. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.