Recognizing the value of telehealth in its infancy

COVID-19 sped up the demand for telehealth. But the more progressive systems had already been investing in ways to offer care and monitor patients from afar. Among the trailblazers in this arena is Norfolk, Va.-based Sentara Healthcare and its CEO, Howard P. Kern.

What was your riskiest decision? In 1999, Sentara Healthcare partnered with a small IT startup to develop and implement the nation’s first tele-ICU. Sentara launched eICU in June 2000, leveraging critical-care physicians and nurses to monitor ICU beds with real-time telemetry, high-resolution cameras, voice communication and an ICU decision-support alert system. From the initial 35 beds in two hospitals, Sentara eICU has grown to 132 beds in eight of our 12 hospitals in eastern Virginia and North Carolina, all monitored from a multistation operations center at Sentara Norfolk General Hospital.

Why was it risky? Telehealth was an unproven concept. There was no data or consensus on whether investing in this untried technology would provide clinical improvements or lower the cost of care. We were breaking new ground, changing ICU workflows and asking physicians, patients and families to trust this concept.

What was the outcome? Sentara saw a 27% reduction in ICU mortality and a 17% reduction in ICU length of stay. One day less in ICU average length of stay provided the equivalent of 12 built and staffed additional ICU beds. More importantly, it helped facilitate earlier interventions with fragile patients and enhanced collaboration between eICU providers and hard-pressed care teams on the floors.

What was the response from those involved? To facilitate early adoption, we presented ICU admitting physicians with three options for participating in eICU: full delegation of patients to eICU clinicians, a partial handoff in which attending physicians were consulted on significant clinical decisions, or no delegation at all. Within a year, our critical-care admitters recognized the clinical benefits of eICU and all had voluntarily shifted to the full delegation approach. More than 40 health systems eventually adopted the Sentara tele-ICU concept after touring our facilities, understanding how to implement the physician decisionmaking model and seeing firsthand the clinical and financial benefits.

Advice to executives in similar positions: Systems with a strong telehealth capability will attract the next generation of patients who will stay for a lifetime. Leaders must evaluate their individual organization’s goals, talent resources, infrastructure, service areas, patient population and ability to invest when considering any new technology.

Describe your leadership style: I am a firm believer in living our mission, putting the customer first, innovating wisely, growing prudently and supporting our people on the journey. This means establishing clear objectives and goals, measuring progress and providing feedback to drive improvement. The key is to encourage leaders to take risks and develop solutions that may be challenging. Additionally, it is critical to create connectivity with our employees, inspiring them to perform their best by harnessing their intrinsic motivation to care for our patients and members.

How would others describe it? I think others might describe me as a strategic thinker who is relentless when it comes to improving patient quality and customer experience. My leadership team knows I often ask “why?” in order to inspire innovative thinking and constant improvement. I believe in developing strong teams and then empowering them to do great things for our patients and members. Settling for the status quo is never acceptable.