Model for Rural Hospital Intensive Care Units for the Future May Be Here Today
By Kurt Hahn, Board Member, Healdsburg District Hospital

"ICU in Small Rural Hospitals are an endangered species" said Dr. James Gude in a recent article in Sonoma County Physician; however Dr. Gude and Healdsburg District Hospital are developing a multi-hospital model that could be the answer for many rural hospitals and even clinics. It is worth close examination and should be considered as a model to participate in.

Dr. Gude, who heads OffSiteCare, has led the installation of Philips digital monitoring robots at Palm Drive Hospital in Sebastopol, Howard Memorial Hospital in Willits, and Healdsburg District Hospital. This system will facilitate Intensivist oversight of ICUs, as well as a wide variety of specialist support in hospital emergency rooms from doctors at off site locations. In the coming months, similar installations are planned for Ukiah Valley Medical Center, Mendocino Coast Hospital, and Sonoma Valley Hospital, and discussions are underway to extend similar services at a number of clinics including Southwest Community Clinic in Santa Rosa, Alliance Medical Center in Healdsburg and Petaluma Health Center. 

The robots offer a wide range of diagnostic tools, consulting intensivists and other specialists. The Philips technology includes a camera for visual inspection of the patient, a stethoscope for auscultation and ultrasound equipment for more detailed examination of the heart, lungs or abdomen and other vessels. Additionally consulting intensivist's can use electronically transmitted medical records, e-rays, as well as CT and MRI scans.

Each participating hospital and clinic additionally has the benefit of 25 evidence-based protocols which bring the latest interventions to the bedside. A recent study of this application of telemedicine for 2000 ICU patients indicated there was a 30% drop in mortality rates as well as a 30% drop in length of ICU stay, which demonstrates the effectiveness of telemedicine.

Through the Santa Rosa Family Medicine Residency Program, Healdsburg District Hospital and its partners, as well as the Southwest Clinic in Santa Rosa, will offer elective ICU rotations for second and third year residents. It is possible that some of the participating residents may decide to work at one of these facilities. The North Coast faces the retirement of almost half of its doctors in the next 5 years, so such initiatives are a key to attracting new doctors.

As a Critical Access Hospital, Healdsburg District Hospital will also be one of the hubs of the FCC funded, “state of the art” medical internet system that will connect rural critical access hospitals to most of the State's premier teaching hospitals. This will allow those already networked north coast hospitals and clinics to call upon a broader range of specialist support and provide an even higher quality care to their patients.

Kurt Hahn serves on the Board of the North Sonoma County District. In 2008 he joined the Board of Trustees of the California Hospital Association. He was also a panelists at the California Health Association  2007 Annual Conference.

Article posted on 1/17/08