ICU Telemedicine Reduces Interhospital Transfers in VHA
MONDAY, June 18, 2018 -- Intensive care unit (ICU) telemedicine is associated with a reduction in ICU patient interhospital transfers, according to a study published online June 15 in CHEST.
Spyridon Fortis, M.D., from the Iowa City Veterans Affairs Health Care System, and colleagues retrieved data for patients admitted to 306 Veterans Affairs ICUs in 117 acute care facilities between 2011 and 2015. Telemedicine was provided to 52 ICUs. Interhospital transfer rates were compared in ICU telemedicine-affiliated hospitals and facilities with no telemedicine program. Data were analyzed for 553,523 admissions: 97,256 to telemedicine hospitals and 456,267 to non-telemedicine hospitals.
The researchers found that from pre- to post-telemedicine implementation periods there were significant decreases in transfers, from 3.46 to 1.99 percent in the telemedicine hospitals and from 2.03 to 1.68 percent in the non-telemedicine facilities. ICU telemedicine correlated with reduced transfers overall after adjustment for demographics, illness severity, admission diagnosis, and facility, with a relative risk of 0.79; reductions were seen for patients with moderate, moderate-to-high, and high illness severity (relative risks, 0.77, 0.79, and 0.73, respectively), and in non-surgical patients (relative risk, 0.82). Patients admitted with gastrointestinal and respiratory admission diagnoses had a decrease in transfers (relative risks, 0.55 and 0.52, respectively). There was no increase in 30-day mortality in association with ICU telemedicine.
"ICU telemedicine was associated with a decrease in interhospital ICU transfers," the authors write.
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Posted: June 2018
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