Telecritical Care Consult FAQ

What is a Telecritical Care Consult?
A telecritical care consult is an adult-oriented (18 years or older) service which involves the use of your existing Providence-supplied telestroke equipment to allow “remote presence” of critical care physicians to hospitals that do not have continuous critical care services. Using technology designed by InTouch Health, Providence Health & Services has contracted with The Oregon Clinic Division of Pulmonary & Critical Care Medicine and Oregon Pulmonary Associates to provide “real time” critical care consultation services to Oregon-based hospitals.

If this service utilizes the same equipment as our existing telestroke program, what happens if the equipment is already in use?
Since the treatment of stroke is very much time dependent, the stroke neurologist will have priority use of the equipment over telecritical care consultations.  Once the stroke neurologist has completed the consultation the critical care physician will log in and perform the telecritical care consultation. 

If I request a consult, what happens?
Consultations are initiated by your local provider (e.g., ED physician, hospitalist, etc.) by calling Providence at 888-777-9599 and requesting a “Telecritical Care Consult.” A critical care physician will be paged and you will be connected. The critical care physician will initially gather necessary information over the phone to determine if a telecritical care consult would be beneficial or if a transfer needs to be considered. If a telecritical care consult is warranted the InTouch Health equipment will be moved to the patient’s bedside and the remote consultation will be provided.

Is there a fee associated with this service?
Your facility will not be charged to utilize this service; however, consulting physicians can bill the patient’s insurance for their time similar to when the consult is provided at the patient’s bedside.

Can a nurse at the bedside call for a consultation?
Like other consultation services, this service is a provider-to-provider based offering. If the nurse or other care team member believes that a telecritical care consult would be helpful they can encourage the attending provider to initiate a consultation.

Do most requests for telecritical care consults result in a patient transfer?
Obviously, based upon acuity, local hospital’s ability to provide the appropriate level of care, etc., some patients will need to be transferred; however, of all the telecritical care consults performed to date, the majority has resulted in patients remaining at their local facility.

Will you provide on-going care for patients?
At this time we do not have the capability to provide on-going care as part of this offering. You will receive a one-time critical care consultation and regular follow-up will not be provided. Additionally, the consulting physicians will only have courtesy privileges at the hospital; therefore, they cannot provide verbal orders to nurses. Critical care physicians will provide recommendations, and the attending provider will need to initiate any necessary orders.

Will you provide pulmonary consultations?
At this time we do not have the capability to provide pulmonary consultations. Any pulmonary issues requiring critical care management will be addressed during the telecritical care consultation.

What if I need more help a few days later?
Participating organizations can request an additional consultation for patients who require just a little more help a couple of days into their hospital stay. However, patients who are requiring frequent critical care physician involvement will need to be transferred to a facility with these services.

Will you provide cross coverage for patients who are already admitted to the hospital?
Patients already admitted should be assessed by the on-call attending provider. If he or she feels the patient would benefit from a telecritical care consult, one can be initiated. It is the expectation that patients have either been assessed, or are in the process of being evaluated, by the local provider prior to the initiation of any request for telecritical care consult services.

How can I help speed up the consultation?
Prior to making the call make sure that all appropriate labs, tests, image studies, etc., have been ordered and are in the process of being completed. For hospitals currently utilizing the Providence Physician Portal, no further steps need to be completed. Hospitals that do not use the Portal should push images per your existing telestroke protocol. All relevant labs, notes, reports, etc., should also be faxed prior to call initiation. Additionally, please be prepared to provide the phone number for the nursing station where the patient is located so the critical care physician can call in and talk to the appropriated care team member to help coordinate the consult.

What can I expect at the end of the consult?
All consultations will accompanied by a full, dictated consultation note providing both initial and ongoing recommendations for the associated patient. Turnaround time for the final consult note is within two (2) hours of the end of the consult.

Who are the physicians providing the consultations?
The Oregon Clinic is the largest private multispecialty physician group in Oregon. Board-certified physicians in its Division of Pulmonary & Critical Care Medicine provide 24/7 in-house critical care and pulmonary services at Providence Portland Medical Center.

Oregon Pulmonary Associates is one of Oregon’s largest pulmonary groups. Board-certified pulmonary and critical care physicians provide 24/7 in-house critical care and pulmonary services at Providence St. Vincent Medical Center in Portland.

In an effort to maintain continuity and help develop relationships with consulting physicians, each hospital contracting with Providence Health & Services will be covered by only one of these groups. However, in the event your primary critical care provider is not available we have the ability to utilize resources from either group to conduct the consult.

For more information contact:
Robert J. “Bob” Mark, MHA, FACHE
Director, TeleMedicine andy Physician Alignment
Providence Health & Services
Department of Medicine and Palliative Care
4805 NE Glisan St., 2M-06
Portland, Oregon 97213