Background
Tele-ICU programs are increasingly utilized to fill resource gaps in caring for critically ill patients. How such programs impact population and bed management within a healthcare system are not known. Mayo Clinic serves as quaternary referral care center for hospitals in the region within the Mayo Clinic Health System (MCHS). In August of 2013, we implemented tele- ICU monitoring at six MCHS hospital intensive care units.
Objectives
To study the effects tele-ICU monitoring on inter-hospital transfers from community-based ICU’s to the quaternary care hospital at Mayo Clinic, Rochester, MN.
Methods
This is a retrospective review of data on inter-hospital transfers comparing trends prior to tele-ICU implementation to those following implementation.
Results
Inter-hospital transfers significantly increased post institution of tele-ICU (p=0.040) and was attributed primarily to transfer from less specialized ICUs, (p=0.037) as compared to more resource intensive ICU’s (p=0.88). However, for such patient transfers, there were no significant differences in before and after severity of illness scores, ICU mortality, or in- hospital mortality.
Conclusion
In a regional health care system, implementation of a tele-ICU program is associated with an increase in inter-hospital transfers from less resourced ICU’s to the referral center, a trend that is not readily explained by increased severity of illness.