Telemedicine Intervention Improves ICU Outcomes

Abstract

Telemedicine for the intensive care unit (Tele-ICU) was founded as a means of delivering the clinical expertise of intensivists located remotely to hospitals with inadequate access to intensive care specialists. This was a retrospective pre- and postintervention study of adult patients admitted to a community hospital ICU. The patients in the preintervention period (n = 630) and during the Tele-ICU period (n = 2193) were controlled for baseline characteristics, acute physiologic scores (APS), and acute physiologic and health evaluation (APACHE IV) scores. Mean APS scores were 37.1 (SD, 22.8) and 37.7 (SD, 19.4) (P = 0.56), and mean APACHE IV scores were 49.7 (SD, 24.8) and 50.4 (SD, 21.0) (P = 0.53), respectively. ICU mortality was 7.9% during the preintervention period compared with 3.8% during the Tele-ICU period (odds ratio (OR) = 0.46, 95% confidence interval (CI), 0.32–0.66, P < 0.0001). ICU LOS in days was 2.7 (SD, 4.1) compared with 2.2 (SD, 3.4), respectively (hazard ratio (HR) = 1.16, 95% CI, 1.00–1.40, P = 0.01). Implementation of Tele-ICU intervention was associated with reduced ICU mortality and ICU LOS. This suggests that there are benefits of a closed Tele-ICU intervention beyond what is provided by daytime bedside physicians.

Impact of the Digital Age on Transforming Healthcare

“…Additional examples of streaming analytics can be seen in the eICU system of VISICU whereby a multitude of patient data is interpreted in real-time and prioritized for a physician and his care team to react to. Earlier trends and sepsis can be identifi ed, and decisions can be prioritized based on immediacy of need and capacity of the providers, not solely in a reactive fashion based on symptoms or lab values [ 15 ]. Chronic disease management, as well as cancer care, stand to make quantum leaps based on streaming analytics in the future.…”

Expanding Technology in the ICU: The Case for the Utilization of Telemedicine

“…Furthermore, an In a large healthcare facility, decreased LOS was significantly related to increased staffing with tele-ICU utilization. 29 Decreased LOS from 4.35 days to 3.80 days after tele-ICU implementation 46,52 Decreased in LOS from 2.7 to 2.2 days after tele-ICU implementation 47 LOS was decreased by 17% with tele-ICU utilization. 18 LOS decreased from 1.18 additional days to 0.96 days after 1 year of tele-ICU utilization.…”

“…46 Mortality rate decreased from 7.9% to 3.8% after tele-ICU implementation. 47 Mortality decreased by 27% with tele-ICU implementation and utilization. 18 Mortality rate decreased in the ICU from 1.0 to 0.65 after 1 year of tele-ICU utilization.…”

Comparison of Death Rate in Hospitalized and Non Hospitalized Intensive Care Patients of Masih Daneshvari Hospital

“…Several factors are influential at the ICU and being aware of them can help the intensive care staff find risk factors and plan to overcome such risks the best way possible and lessen the death rate (4). The quality of care at the ICU can affect death rate of hospitalized patients (6). Due to the limited space of intensive care units, it is necessary to prioritize patients with severe conditions so that they receive greater attention from nurses and doctors in a defined system (7).…”