Title: Pellerito's Corner: Winter 2016
Author: Peter Pellerito, President & CEO
Facility: ImaCor Inc. Garden City NY

The healthcare industry underwent major changes in 2015 with multiple payers and hospital consolidations, substantial cost controls, and the move from fee for service to a value based system. Some would say that for intensive care medicine, it’s all a matter of time; we say let’s focus on time specifically: How can we improve patient outcomes, quality and value through reduced delays in decision making, increase our efficiency as caregivers, and ultimately improve our critically ill patients’ trajectory by getting it right, faster?

Our solution is hTEE – direct continuous visualization on demand at the bedside in those critical moments when it is needed most. Hypovolemia, cardiac dysfunction, fluid overload? Through ultrasound guided management you are literally ‘seeing’ the root cause of instability sooner in order to more appropriately determine fluid status, reduce time to stability, time on the vent, and even time in the unit and hospital. We will be more efficient in our workflow and better guide management of the patient. And in this global environment of change, it’s still the patient who needs us most.

In the 2nd half of 2015, my team and I launched critical initiatives focused on improving clinical efficiency. Our educational Technician Model simplifies the training process to improve user workflow and coverage. By expanding the core team of users knowledgeable in the technical aspects of performing and communicating the hTEE 3-view study, department leaders are improving the quality of care, positively impacting patient outcomes, and ultimately creating more economic value for the hospital. This dovetails with our hTEE risk-sharing program, an all-in-one solution whereby ImaCor works in partnership with both the hospital’s clinical and administrative teams to understand opportunities to improve value. As a group, we categorically track individualized metrics to clearly show the economic value realized through increasing efficiency, reducing delays, and improving patient outcomes. We have extended the scope of impact with our hTEE Care Coordination initiative that enables hTEE guidance of high-risk surgery patients, early interventions of fluid management, and streamlines the perioperative flow of hemodynamic management information between the OR and ICU. Early reports from pilot programs currently underway indicate hTEE Care Coordination improves workflow efficiency while reducing the use of blood products and various methods of support.

And while our focus is on time, I want take a moment to congratulate Robert Sladen MD and Ib Jammer MD, PhD on their session, “Strategies to Improve Outcome After Surgery,” at the recent annual meeting of the European Society of Intensive Care Medicine (ESICM).1 Dr. Sladen addressed perioperative optimization of left and right ventricular function; the change of postoperative vasoplegia; and, specifically, the role of postoperative hemodynamic transesophageal echocardiography (hTEE) in guiding management. It is also an honor to congratulate Amy Christie MD on the “Clinical Utility of hTEE in the Post-Resuscitation Phase of Trauma Patients Receiving Massive Transfusion Protocol,” presented at the annual meeting of the American Association for the Surgery of Trauma.2 The conclusion of the study is that hTEE management is beneficial to the care of patients undergoing massive transfusion protocol (MTP) as it immediately and continuously identifies any departure from euvolemia throughout the patient’s extended course of care. These are some of the most recent studies; I look forward to sharing the results of ongoing multicenter hTEE studies throughout this year.

Improving efficiency improves outcomes and reduces costs. Simply, it saves lives and it saves money. Thank you for your continued support and commitment to optimizing hemodynamic management.

I wish you a healthy, happy, and productive 2016.

With warmest regards,

Peter

PS: Please feel free to contact me anytime at This email address is being protected from spambots. You need JavaScript enabled to view it..

 


1 Jammer L, Sladen R; Strategies to Improve Outcome After Surgery. Presentation at: Thematic Session. 28th annual European Society of Intensive Care Medicine 2015 Annual Congress; 2015 October 3-7; Berlin, Germany.

2 Christie A. et. al. Trauma Patients Receiving Massive Transfusion Protocol. Poster session presented at: 74th annual AAST and Clinical Congress of Acute Care Surgery; 2015 September 9-12; Las Vegas, NV.