TeleCritical Care ensures the best care, anytime, anywhere

Friday, January 24, 2025

[6 MIN READ]

The Providence TeleCritical Care team closely collaborates with nurses and doctors at regional hospitals across the western U.S. to provide specialized 24/7 patient monitoring and care.
Providence patients who receive TeleCritical Care tend to spend fewer days in the ICU, are more likely to survive and are less likely to be transferred to a hospital outside their community.
Learn how TeleCritical Care at Providence saves lives and turns caregivers into superheroes.

No one plans for a medical emergency. So what happens when you need specialized care, which your local hospital can’t provide?

Providence TeleCritical Care gives you access to caring and experienced critical care clinicians at times when you need it most.

Creating superheroes

“Health care is one of these things that you don’t really think about until you need it,” says Chris Dale, M.D., medical director of Clinical Innovation at Providence.

Say your heart stops. Someone calls an ambulance. A team does CPR and drives you to the nearest hospital. There, you are going to need specialized and ongoing acute care, which may or may not be available. But with the services provided by Providence’s Virtual Care and Digital Health team, “we just beam in,” Dale says.

When the virtual care delivery team “beams in” in real-time, they can see exactly what is happening through the use of technology, including high-quality video, microphones and special software. Two-way video allows the virtual care team to monitor 24/7, review the care plan with the patient and family, adjust treatment quickly and advise interventions via videoconferencing to the bedside care team.

And that’s how the Providence TeleCritical Care team creates superheroes.

“We create super nurses and doctors at these local sites to help them be the best caregivers they can possibly be,” Dale says. “We are a phone-a-friend” when we beam in. We make it so that even if you’re in a remote place, you can get the best care possible.”

Take, for example, a recent case at Providence Kodiak Island Medical Center in Alaska.

“This gentleman who came in was really kind of pushing the limits of what can be done at a critical access hospital,” Dale says. “He had a small bowel obstruction and got surgery for it, which was great. The general surgeon did an awesome job.”

But as the patient was being wheeled out of the hospital, he had a cardiac arrest.

“Cardiac arrests are semi-common, but if you’re at a critical access hospital, there might be only one or two a year,” Dale says. “So this was really rare. And even if you are at the best hospital, survival is still a little less than half.”

The Kodiak Island Medical Center care team got the patient’s heart going again and hooked him up to life support. However, they were having difficulty ventilating him.

“His blood pressure was super low, and it really required the expert docs and nurses in TeleCritical Care to stabilize those things,” Dale says.

“A lot of critical care is knowing when to act and when not to act. When the adrenaline flows in our bloodstreams and things are kind of frenetic, it’s really easy to lose situational awareness. Having experienced ICU nurses and doctors can orient the care team with a very systematic approach. I don’t think there’s any magic in terms of what we do in critical care medicine, but I think it’s being able to apply these principles to really sick people in difficult situations that allows patients to do well.”

The next day, the man was airlifted to Providence Anchorage Medical Center and recovered.

“Together, we were able to take an objectively difficult situation, which statistically has a likelihood of a bad outcome, and convert it into a situation in which this gentleman is now doing well, is back to his life, and coming by the hospital to drop off food in thanks to his care team.,” Dale says. “That’s super cool. That’s a very clear save. It illustrates the teamwork, not only with the TeleCritical Care team but also in collaboration with the boots on the ground.”

How TeleCritical Care works

Our TeleCritical Care team combines years of ICU experience with advanced monitoring technology, alerts and artificial intelligence to collaborate with critical care nurses and critical care physicians at all our critical access hospitals. It’s a virtual care system built on a foundation of teamwork, trust and collaboration.

Most of our nurses already had 10 years of ICU experience or more at the bedside before they became virtual nurses. They and the virtual provider team provide 24/7 support to staff at our partner hospitals.

“We use cameras to beam in when we’re rounding on our patients,” Caroline Raganit, RN, BSN, CAVRN, telehealth clinical operations director at Providence. “We’re physically looking at the patients, looking at the medications, the ventilator, comparing the data that we see to the data in the chart. We do that continuously with our nurses. And if we see something, we will say something.”

ICU patients aren’t always stable. Raganit and her team use technology to help identify patients experiencing changes in their condition. When a nurse at a partner hospital is presented with a procedure or diagnosis they’re not familiar with, they can call a TeleCritical Care nurse, who then serves as a second set of eyes.

“We can guide them through a procedure via the camera,” Raganit says. “We’ve done that a lot, especially for our sites that are further out where they may rarely experience advanced ICU procedures or work with specialized equipment.”

Cameras and microphones in patient rooms also allow TeleCritical Care staff to talk directly with family and loved ones.

“With critical care, we deal with a lot of situations where patients may not survive,” Raganit says. “So you have that emotional connection with families and patients, supporting them throughout that period. Our nurses have that skill to take care of our patients emotionally.”

The benefit of keeping loved ones close by

TeleCritical Care often results in better patient outcomes. Patients who receive TeleCritical Care tend to have a reduced length of stay in the ICU and in the hospital. Implementing TeleCritical Care at Providence has reduced transfer rates by 7% to 38% depending on the hospital, with smaller hospitals seeing the most significant decrease.

“You want to transfer to a higher level of care if you need to, but you don’t want to if you don’t have to,” Dale says. “We make it more likely that you don’t have to. And for us, that is a win-win because people don’t like to go elsewhere.”

There’s a benefit to receiving patient care in your own community with the support of nearby family and friends.

“Experientially, having loved ones with you is enormously helpful,” Dale says. “Up to 80% of people in the ICU experience delirium. People just get confused. But having loved ones at the bedside comforts people — they’re less likely to have delirium, they’re more comfortable, their pain is less.”

What makes TeleCritical Care at Providence different

Not all virtual critical care services are the same.

“A lot of telehealth is known to be consultative,” Raganit says. “You need a provider or a specialist or a consult, you call them up and it’s a one-time interaction. With Providence TeleCritical Care, we’re continuously managing the patient. It’s like you’re in an airport. We’re the flight tower. We’re seeing all the things happening using our screens, our tools and our technology. We’re trying to divert any crashes by reaching out proactively to nurses; when we see data on the computer, we need bedside eyes to confirm our assessment.”

Consider, for example, the story of an active woman in her 50s who recently participated in a cycling race across the country. The woman became exhausted in a small town in Washington that had a population of less than 1,000. Her teammates called EMS, and a helicopter transported her to Providence Mount Carmel Hospital.

The woman’s labs showed she was experiencing dangerously low sodium. The woman’s husband, an anesthesiologist and medical chief in another state, flew to Seattle and drove to Mount Carmel to be with her. The husband was impressed with the extraordinary care his wife received throughout the day. Still, he was worried when the hospital’s on-site physician prepared to leave for the night. Then, he learned that a TeleCritical Care team would be monitoring his wife throughout the night. The woman recovered, and her husband was grateful for the exceptional 24/7 care his wife received despite the hospital’s size and available on-site clinicians.

“That’s the big difference,” Raganit says. “Other critical care services are consultations. If you need something, they’ll call. They may not necessarily know the patient at all. But our entire team, our doctors who are rounding with our patients, they are aware of the patients monitored in our program.”

Contributing caregivers

Chris Dale, M.D., is the medical director of Clinical Innovation at Providence TeleCritical Care.

Caroline Raganit, RN, BSN, is the clinical operations director at Providence TeleCritical Care.

Find a doctor

The TeleCritical Care providers at Providence support critically ill patients by enhancing support for your local hospital-based care team. If you are looking for a primary care provider, you can search for one who’s right for you in our provider directory.

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