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Avera eCare



Avera eICU CARE links intensive care units to an around-the-clock care team led by intensivists (specialists in critical care). Cameras in patient rooms allow the Avera eICU CARE team to closely examine critically ill patients. Decision-support software continuously analyzes patient specific data, alerting the team to changes in a patient’s condition. Avera eICU CARE physicians work hand in hand with local providers to implement cutting-edge patient care practices and decrease the risk of serious complications.

Sepsis Hospital Mortality RatioNationwide, a shortage of intensivists has left the most critically ill patients without specialists trained to deliver their care. In fact, some estimate that only 13 percent of ICU patients receive care from a dedicated intensivist. Avera eICU CARE is one solution to this problem. Because of Avera eICU CARE, more than 60 percent of the ICU patients in the region receive care oversight provided by an intensivist. Through the use of advanced monitoring software and integrated electronic medical record systems, Avera eICU CARE has reduced length of stay and cost of care for critically ill patients across the region.

Since 2004, nearly 61,000 patients in facilities across the upper Midwest have been monitored by Avera’s team of critical care experts. Of these patients, 1400 who were predicted to die left the hospital alive because of the care provided.

Avera eICU participating in the formation of Evidence Based Care

Avera eICU, and 2 other partner hospitals will be participating in a study with the University of Pittsburg in the coming year. This study aims to understand the clinical and organizational factors that influence telemedicine effectiveness. There will be onsite visits and the investigation of the interactions between the ICU and eICU and the role of staff in the bedside patient care. eICU looks forward to contributing to the greater body of knowledge in telemedicine through their participation.
eICU® is a registered trademark of Philips VISICU, Inc.



Avera eEmergency supports rural clinicians in the delivery of highest-quality care, resulting in earlier interventions, improved use of evidence-based medicine, reduced unnecessary transfers, reduced complications and lives saved. Since its inception in 2009 as a pilot in eight critical access hospitals in eastern South Dakota, eEmergency has grown to serve 100 hospitals across 545,000 square miles and eight states. The coordination of care through nursing documentation and transfer coordination is an added benefit to these hospitals. This translates directly into better care, better health outcomes and reduced costs for residents.

More than 15,000 patients have been seen over video through eEmergency, and an additional 18,000 patient transfers have been coordinated through the service. In a recent survey, 100 percent of rural clinicians and administrators agreed that eEmergency services are an important part of the delivery of emergency care in rural communities.

eEmergency Airway Management Initiative

First Pass Intubation Successes by Device 2014Emergency airway management poses a unique challenge in the rural setting. For many rural clinicians, intubation is not a skill that is performed on a routine basis. Because of this, emergent or complex intubation becomes even more daunting. By utilizing a video laryngoscope linked to the eEmergency system, rural providers have immediate access to an experienced emergency trained physician who can guide them through the intubation procedure.

Since 2012, eEmergency has worked hard to help customer sites obtain access to video laryngoscopes. 90% of the current eEmergency sites have access to the use of a video laryngoscope. Because access to the tools is not enough, the Avera Airway Management course has been designed in partnership with nationally acclaimed airway management clinical educators in order to provide excellent education closer to the customers and at a more affordable cost. In the last two years 110 providers have participated in this course. The eEmergency staff also provide on demand education to any site who seeks it. Recent data evaluated shows a first pass intubation rate of 71% and an any pass success rate of 94%.



Top 5 Specialties Utilizing eConsultAvera eConsult connects rural patients in clinics and hospitals to specialists in urban communities across the region. Currently, eConsult connects 132 rural sites with 33 different specialties, conducting more than 10,300 clinic visits in the last year. eConsult removes significant access barriers for patients.

Last year, eConsult services have saved $1million in patient expenses and more than 39,000 hours in patient travel time. In the last year alone, eConsult services saved patients more than 2.5 million miles.

#1 in Access to Telemedicine

In a recent Telemedicine and e-Health journal study, South Dakota was ranked number #1 in the nation in providing telemedicine services to Medicare beneficiaries. Avera eConsult, is instrumental in providing the nation’s best access to telemedicine.

The statistics referenced are from 2012,but eConsults encounters have grown by nearly 34% since 2012. Rankings are based on the relative Medicare spending on telemedicine per beneficiary.



Avoidance of Seius Safety Events
  • 2.3 Million Orders Reviewed
  • 26,000 Avoided Serious Safety Events
  • $68.3 Million Saved

Avera ePharmacy has improved medication safety for more than 704,000 patients in 63 hospitals across the region. For the first time in these hospitals’ histories, ePharmacy has ensured pharmacist review of all new medication orders.

Since inception, hospital-trained pharmacists housed in the ePharmacy hub have reviewed more than 2.2 million medication orders for drug-drug interactions, allergic reactions and duplicative therapies. In the last year, a team of pharmacists complete more than 11,000 interventions to promote medication safety and cost-effectiveness in rural communities. Many of these interventions represent significant increases in medication safety and efficacy for patients.

ePharmacy is Fast and Accurate

The ePharmacy team at eCARE provides around the clock access to clinical pharmacy services for inpatients and outpatients. ePharmacy reviews an average of 55,000 orders per month. Over the last year the average turnaround time for a pharmacy order review (STAT and routine) was 17 minutes. Within that order time, orders were verified, and reviewed with 99.9% accuracy.



Improved Access and Outcomes Related to Avera’s eLTC

eLTC, the newest Avera eCARE service, launched in January 2012. eLTC is designed to provide urgent care services to residents in long-term-care facilities, increasing timely access to appropriate care and reducing unnecessary transfers from the facility.

eLTC is now LIVE in 33 long term care facilities. 800 resident video encounters have occurred. These have resulted in 500 potentially avoidable transfers. Residents and facility staff report high levels of satisfaction with the service, agreeing that it is less stressful and exhausting for the residents while allowing the resident to receive appropriate care quickly.

Avera Virtual Care Center

Total Video Encounters 2014In September of 2014 the eLTC team embarked on a 3 year journey and began new programming as participants with CMS as an Innovation Awardee. This CMS Innovation program is designed to test new models of care. This team now includes an expansion of urgent care services to include the availability of support to the long term care facilities in many areas.

Some of these areas include a geriatric certified ePharmacist to help with medication reviews, and interventions, and a board certified geriatrician to lead a team of advanced practice providers in a revolutionary new way of supporting the care plans of long term care residents. In addition to this other team members are providing support in the field for training to build the skills of staff to prevent, and identify declines in resident’s health promptly.

The goal of this model is to keep residents in place for their care, and avoid unnecessary transfers. This is achieved by providing tools to staff, and expanding access to telemedicine through the virtual care center team as well as other specialist providers in the Avera eConsult network.

Live Better. Live Balanced. Avera.

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