The VISICU Vision
Two nationally recognized intensivists from Johns Hopkins Hospital founded VISICU with a unique vision for improving patient outcomes in the ICU. The company offers a powerful solution that combines information systems and telemedicine technology to create a uniquely proactive approach for delivering ICU care. The result is a proven solution that dramatically reduces clinical complications, improving patient outcomes and mortality with the added benefit of minimizing hospital costs.

The "Prevention Effect"
Numerous studies have demonstrated that intensivist* involvement in the care of ICU patients helps prevent complications, leading to double-digit improvements in patient outcomes. In 2000, the Leapfrog Group, a patient safety initiative representing Fortune 500 companies, called for full-time intensivist staffing as a way to save more than 50,000 lives per year. Unfortunately, there is a severe shortage of intensivists. Less than 6,000 actively practicing in the U.S., leaving less than 15% of ICUs receiving dedicated intensivist care. With our aging population, we can expect to experience an even greater shortage in the future.

The VISICU eICU^® Care Approach
A 2001 independent Cap-Gemini, Ernst & Young study showed that VISICU's eICU^® solution reduces mortality and lowers costs while leveraging intensivist expertise to more patients across ICU facilities. The eICU^® is located apart from the hospital ICU and does not house patients or replace the hospital ICU. The eICU^® is staffed with experienced intensivists and seasoned critical care nurses who are linked by voice, video and data linked to multiple hospital ICUs through hub-and-spoke networking. The eICU^® team provides 24/7 patient care, executing predefined care plans or intervening in emergencies when a patient's attending physician is not in the ICU. The eICU^® is powered by VISICU's eVantage system which integrates these technologies:

1. Relational database for actionable patient knowledge: Seamless care transition occurs between ICU and eICU^® care providers through the sophisticated eCareManager™ software system, which presents a dashboard-style user interface for fast clinical analysis of a patient's condition and assigned tasks.

2. Software alerts to avoid adverse events: Care interventions occur earlier because monitored patient information is processed through the company's Smart Alert™ proprietary software, which evaluates patient data for physiologic thresholds and trends and flashes an alert when a patient is straying "out of bounds". Noting the alert, the eICU^® intensivist executes an intervention strategy, often precluding an adverse event in advance.

3. On-line decision support: Standards of care are maintained and often improved because clinicians have on-line access to the VISICU evidence-based care guidelines, a comprehensive and interactive on-line database that supports algorithm-driven interventions for diagnosis and treatment. Care recommendations are regularly updated using evidence-based medicine, society guidelines, and input from an international panel of experts.

4. Outcomes tracking: Clinical outcomes, resource utilization and operational efficiency are tied to the Agency for Healthcare Research & Quality (AHRQ) recommendations and are tracked daily and quarterly with the VISICU Smart Report™ System. Patient queries can also be customized for research purposes.

Results
The remote intensivist management concept was validated for feasibility and effectiveness in a 1997 trial at an urban, academic-affiliated community hospital in Baltimore (Rosenfeld, B.A. et al: ICU Telemedicine--An Alternate Paradigm for Providing Intensive Care: Critical Care Medicine, 28; 3925-3031, 2000). The results demonstrated a 30% reduction in severity-adjusted hospital mortality for ICU patients, 40% reduction in clinical complications, and 28% reduction in ICU length of stay.

Sentara Healthcare, a six-hospital system in Norfolk, VA, installed the VISICU eICU^® solution in 2000. It currently manages up to fifty patients in five ICUs, at three Sentara hospitals. A 2001 Cap-Gemini, Ernst & Young study documented these striking results at Sentara Norfolk General Hospital:

	25% reduction in severity-adjusted hospital mortality for ICU patients
	17% reduction in ICU and hospital length of stay
	Savings in healthcare costs of $2,150 per patient or 3 million dollars in financial benefit above the entire program costs