Walter Reed Bethesda Opens Hub in Joint Tele-Critical Care Network

Photo By Bernard Little | A screen shot from Walter Reed Bethesda's hub in the Joint Tele-Critical Care Network shows how it can connect with Naval Medical Center San Diego as part of the JTCCN. Walter Reed National Military Medical Center opened its hub in the JTCCN May 25. “The JTCCN is a tele-critical care platform created by Naval Medical Center San Diego (NMCSD) with intensivists privileged via the Virtual Medical Center Front Office to treat critically-ill patients at military treatment facilities (MTFs) throughout the Military Health System (MHS). JTCCN meets most accreditation requirements for access to critical care physicians [and] critical care expertise,” explained Army Maj. (Dr.) Nikhil Huprikar, chief of Pulmonary and Critical Care Medicine Service at WRNMMC.  

UNITED STATES

06.08.2022

Story by Bernard Little 

Walter Reed National Military Medical Center

Focused on enhancing access to care, safety, readiness and innovation, the leadership at Walter Reed National Military Medical Center opened its hub in the Joint Tele-Critical Care Network (JTCCN), also called “tele-ICU,” on May 25.
Army Brig. Gen. Jack Davis, WRNMMC director, and Army Maj. (Dr.) Nikhil Huprikar, chief of Pulmonary and Critical Care Medicine Service at WRNMMC, cut the ribbon to open the service, which encompasses a tele-care suite in the hospital.
Huprikar led the charge in bringing the capability to Walter Reed Bethesda and explained multiple accreditation boards for health-care facilities require 24/7 access to a critical care physician to maintain good standing. “The JTCCN is a tele-critical care platform created by Naval Medical Center San Diego (NMCSD) with intensivists privileged via the Virtual Medical Center Front Office to treat critically-ill patients at military treatment facilities (MTFs) throughout the Military Health System (MHS). JTCCN meets most accreditation requirements for access to critical care physicians [and] critical care expertise,” he stated.
He added NMCSD created the tele-ICU to address challenges with critical care services at Camp Pendleton, California, which are also faced at other MTFs and include a limited number of critical care physicians, constant rotational responsibilities, and low acuity and low census in attempts to maintain critical care access.
The network produced at San Diego offers 24/7 coverage, amplified with hub sites at Madigan Army Medical Center on Joint Base Lewis-McChord in Washington state, and Brooke Army Medical Center on Joint Base San Antonio-Fort Sam Houston, Texas.
“The Defense Health Agency’s adoption of JTCCN at all MTFs with critical care aspirations or intentions can represent a long-term solution to improve critical care access at low acuity, low census facilities and reduce network costs,” Huprikar furthered. “Maintaining critically-ill patients at MTFs increases the case-mix and complexity of patients, which can enhance the competencies of MTF providers and the JTCCN intensivists supporting their care.”
“This keeps Walter Reed on the cutting edge, and ‘the Flagship of Military Medicine needs to be on the cutting edge,” Davis said. “These are the kinds of things that helps us do that. If you’re not moving forward, innovating, or trying to do so, you’re stagnating. We don’t want to do that here,” he added.
“We really do see [JTCCN] as the wave of the future,” added Army Lt. Col. (Dr.) Jason Blaylock, director for Medical Services at WRNMMC. “When we look at minimal manpower for critical care physicians across the MHS, but also the need to have critical care assets at smaller, outlying MTFs across the region, this is a way we can solve those challenges moving forward. I think it will be a huge step in the right direction for our organization,” he furthered.
Huprikar agreed, adding that tele-ICU is not only a “massive step forward” for WRNMMC, but the MHS as a whole. “With this we get to help support providers throughout the MHS take care of critically-ill patients within the constraints of their local environment, and [tele-ICU] can be done far forward.” He explained in addition to providing coverage to continental U.S. MTFs, JTCCN has been used outside of the continental U.S. in places including Guam, Japan, Spain and Djibouti.
A benefit of JTCNN allowing for 24/7 ICU coverage is “the needs for critical care patients are often acute requiring responses and interventions within minutes to hours. The access to critical care providers must have an immediacy to their interaction,” Huprikar stated.
At WRNMMC, support of the JTCCN will call for intensivists to work in 12-hour shifts to provide access to critical care physicians [and] critical care expertise, Huprikar explained. He added that currently, the service of JTCCN at WRNMMC “have no overt cost. Hardware and software have been supported through the NMCSD’s Virtual Medical Center. Longer term use of the JTCCN will involve expansion of hardware technology to allow providers to work from distant locations away from WRNMMC.”
He also explained that NMCSD is experimenting with the use of a Da Vinci machine and augmented and virtual reality to support possible distant surgical capabilities. In addition, officials are also exploring including other specialties, such as tele-stroke, tele-NICU/PICU, tele-sleep, and more, “to expand the footprint beyond the singular critical care physician.”

• Date Taken: 06.08.2022
• Date Posted: 06.08.2022 12:02
• Story ID: 422493
• Location: US