How Baltimore’s ICmed used telemedicine to help NYC’s frontline doctors during the COVID-19 surge

As COVID-19 spread rapidly in New York during the pandemic, hospitals’ intensive care units in New York were met with an influx of patients. In a statement released April 30, Dr. Mona Krouss, patient safety officer at NYC Health + Hospitals, described a situation where hospitals had four to five times the number of patients as usual in the ICU.

While many from outside watched the number of beds and protective supplies closely, those weren’t the only needs inside the hospital. With a surge in patients that needed critical care, hospitals also faced a shortage in specialists in this area.

“The reality is it’s not just a bed situation. There’s this whole issue surrounding the actual clinical staff,” said Anil Kshepakaran, founder and CEO of Baltimore digital health company ICmed. “In some cases, one hospital might have two critical care specialists on staff, if they’re lucky.”

But in a crisis, doctors were on the frontlines no matter what specialty they had, so there was a need to equip physicians who don’t typically provide critical care with training and support to provide consultations for patients and use equipment like ventilators.

It became an area where digital health tools like video chat and direct messaging from ICmed could play a role. Partnering with doctors from Maryland and North Carolina, the Highlandtown-based company’s platform was put to work offering teleconsultation for physicians at Woodhull Medical Center in Brooklyn and Jacobi Medical Center in the Bronx.

After ICmed adapted its platform in April, doctors outside New York were able to conduct virtual rounds via video with a patient at the hospital and provide guidance. Physicians from the Society of Critical Care Medicine — Baltimore Chapter and Charlotte-based Atrium Health recruited 30 critical care attending physicians who volunteered their time to provide coverage. Over about a month, they completed about 350 patient encounters. Along with walking through specific steps, the specialist can guide a patient directly at the bedside, pointing things out or observing specific readings.

While the pandemic was a moment of crisis that will pass eventually, the telemedicine tools that were deployed quickly during this time will remain. Kshepakaran could see additional uses for these remote consultations that go beyond critical care, such as in rural areas.

“If you’re doing rounds with a group of fellows or doctors, you don’t always have to be present for that — you can actually plug in specialists remotely,” he said.

In a setting where there aren’t specialists on hand, it could help a doctor who is not trained a specific area connect with a specialist via video calling and certain data elements.

“There’s no border limitations here,” Kshepakaran said. “It’s just a function of video calling and being able to have access to certain data elements.”

Along with device and data integrations, ICmed also offers record keeping and monetization tools for hospitals, the founder said.

Telemedicine has been embraced during the pandemic, with state leaders in Maryland passing new legislation to allow for specific kinds of visits, and hospitals seeking remote care options when face-to-face contact is limited. But these policy shifts appear poised to result in long-lasting changes to healthcare. For a company like ICmed, which has already been building a solution centered on “nimble telemedicine” that’s centered on care outside the hospital walls, it’s bringing validation and increased interest from potential clients. So instead of going back to the way things were, Kshepakaran is looking at the “new normal” going forward.

“We’re going to want things to be accessible,” he said.