Bailing on Bunkers

September 5, 2013 by InTouch Health

There are essentially two approaches to teleICU: using centralized bunkers vs. the decentralized strategy. The bunker option is doing well in many nations around the world, but it’s losing steam in the U.S. Judging by recent events in Maine, the days of the bunkered approach in America may be numbered.


MaineHealth recently bit the bullet and closed down the VitalNetwork bunker-style command center it had been operating for eight years. A MaineHealth spokesperson estimated that continued operation would have led to a $500,000 annual deficit.


Here’s the bottom line: remotely managed ICU bunkers are just too expensive to build and operate, and participating hospitals can’t afford the ongoing fixed expenses – especially when no reimbursement is available. In contrast, the Remote Presence/decentralized approach delivers similar benefits at a fraction of the cost.


The demise of the VitalNetwork system is a real blow to quality care in rural communities across Maine. The Portland command center had been used to link ICU specialists with caregivers at nine hospitals statewide, including four outside the MaineHealth network.


But above all, New Englanders are practical and thrifty. After nearly a decade, they finally had to admit that the high cost of building and running a brick-and-mortar telemedicine command post was simply not sustainable.


In every business, competing methodologies clash until the best one wins. That was true when George Westinghouse and Thomas Edison battled it out over whether AC or DC would be the electricity standard for the U.S. And now it appears that America’s bunker vs. Remote Presence competition is nearing an end. The bunker proponents put up a good fight, but a more affordable, decentralized model is proving superior. It’s a different story internationally, but there may come a day when other nations choose the decentralized solution as well.

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