Telemedicine Cuts Inter-Hospital ICU Transfers of Critically Ill
WEDNESDAY, Aug. 1, 2018 -- Telemedicine is associated with a decrease in inter-hospital intensive care unit (ICU) transfers, according to a study published in the July issue of CHEST.
Spyridon Fortis, M.D., from the Iowa City VA Health Care System, and colleagues compared the effect of ICU telemedicine on inter-hospital transfers based upon data from 306 Veterans Affairs ICUs in 117 acute care facilities between 2011 and 2015. Two support centers located in Minneapolis and Cincinnati provided telemedicine services to 52 ICUs in 23 acute care facilities.
The researchers found that there were 553,523 admissions to VA ICUs (97,256 to telemedicine hospitals and 456,267 to non-telemedicine hospitals). In the pre-and post-telemedicine implementation periods, transfers decreased significantly in the telemedicine hospitals compared to the non-telemedicine facilities (P < 0.001). ICU telemedicine was associated with overall reduced transfers, with a relative risk (RR) of 0.79 (P < 0.001), after adjusting for demographics, illness severity, admission diagnosis, and facility. This reduction occurred in patients with moderate (RR, 0.77; P = 0.034), moderate-to-high (RR, 0.79; P = 0.035), and high illness severity (RR, 0.73; P = 0.003), as well as in non-surgical patients (RR, 0.82; P = 0.001) and patients admitted with gastrointestinal (RR, 0.55; P < 0.001) and respiratory diagnoses (RR, 0.52; P < 0.001). There was no increase in 30-day mortality associated with ICU telemedicine.
"ICU telemedicine may have helped to triage and not transfer patients that could be appropriately treated in local ICUs by providing remote access to critical care expertise," the authors write.
Posted: August 2018