A Decentralized Model for Tele-Critical Care For the entire history of critical care telemedicine, the practice of tele-ICU has been primarily associated with central command centers. Central command centers, also referred to as bunkers or hubs, link intensivists and other personnel to multiple hospitals so that a relatively small number of critical care physicians can oversee the care of a large number of ICU patients. Capital costs of construction, installation, and training for a new command center range from $6 million to $8 million . At a time when healthcare costs must be minimized, reconsidering the value of central command centers is necessary. In numerous studies , tele-ICU has shown to improve patient outcomes and decrease mortality as well as ICU length of stay. Tele-ICU has clearly shown value in keeping patients closer to home, allowing smaller hospitals to treat high-acuity situations. So the question is, how key is a central command center to an effective tele-ICU progr...

The CEO of Omnicure, Sanjay Subramanian, MD , has a great deal of tele-ICU experience. His experience and leadership in critical care medicine have given him insight into cost and revenue centers in tele-ICU. As the prohibitive costs of legacy tele-ICU systems present a significant barrier, a primary motive of Omnicure is to provide a low-cost telemedicine ICU service. In the 2019 publication, Telemedicine in the ICU [1], Sanjay co-authors a chapter titled “Cost Benefit Analysis of Implementing Telemedicine in the ICU.” Costs of tele-ICU are broken down into the following categories: Hardware Fixed mounted cameras in patient rooms Cabling for cameras Desktop computers and multiple monitors for remote physician/nursing workstations T1 lines to assure connectivity Software  Staffing costs The chapter details the maintenance and support costs of hardware, as well as the staffing support of tele-ICU command centers. The hardware and IT costs are quite significant. For example, the har...

Omnicure was founded to innovate the delivery of critical care. Almost 3 years ago our team banded together to create an intuitive, simple, and mobile-friendly solution to provide tele-critical care with no hardware costs for the hospital. Our primary motives? The belief that healthcare as a whole can be improved through efficient allocation of physician resources. The commitment to provide critical care expertise to settings without intensivists. Whether that is a Critical Access Hospital with a small ICU, or an ED where high-acuity patients wait to be transferred to a hospital bed, we set out to create a model that enabled bedside providers to easily connect with intensivists. Sanjay Subramanian , a critical care physician in St. Louis, experienced the inefficiencies of legacy tele-ICU systems and considered the limitations. He saw an opportunity to make a positive change. Having previously practiced in Seattle, Sanjay reconnected with old friends and colleagues including Paramesh Va...