Efficacy of TeleICU

Multi-center Study of ICU Telemedicine Reengineering of Adult Critical Care Craig M. Lilly, MD,a,b,c,d John M. McLaughlin, PhD, MSPH,e Huifang Zhao,c,d Stephen P. Baker, MScPH, (abd),d,f,g,h Shawn Cody, RN, MSN, MBA, and Richard S. Irwin, MDa,g for the UMass Memorial Critical Care Operations Group*, CHEST

  • Study of 56 ICUs in 32 hospitals, across 19 US health systems (Adult patients: n = 118,990 (11,558 control, 107,432 intervention)) evaluating the overall effect of teleICU care and its individual components on clinical outcomes, mortality and LOS.
  • Both ICU and hospital mortality in the teleICU intervention group were significantly better than controls. Additionally, after adjustment, ICU LOS for ICU telemedicine intervention patients was 20% shorter and hospital LOS was 15% shorter compared to controls.

Intensive care unit telemedicine: alternate paradigm for providing continuous intensivist care Rosenfeld BA, Dorman T, Breslow MJ , et al. Crit Care Med . 2000 ; 28 ( 12 ): 3925 – 3931

  • 16-week study of patients in a 10-bed surgical ICU. Pre-study, intensivist consultation was available but there were no on-site intensivists. During the study, tele-intensivists used remote monitoring technology (video and electronic data transmission) to manage patients together with onsite staff.
  • Results were assessed against two 16-week periods within the year before the change. ICU LOS decreased by 34% and 30%, and ICU costs decreased by 33% and 36%, respectively. The cost savings were associated with a lower incidence of complications.
  • Variable costs decreased by 24.6% per case.
  • The number of ICU cases per month increased by 7% as a result of capacity created by ICU LOS reduction.
  • The monthly contribution to the margin increased by 66% during the intervention period.
  • Severity-adjusted ICU mortality decreased during the intervention period by 68% and 46%, compared with baseline periods one and two, respectively.
  • Severity-adjusted hospital mortality decreased by 33% and 30%, and the incidence of ICU complications was decreased by 44% and 50%.

ICU Telemedicine Program Financial Outcomes 151 #2 CHEST, February 2017. Craig M. Lilly, MD, FCCP; Christine Motzkus, MPH; Teresa Rincon, RN, BSN; Shawn E. Cody, PhD, MSN/MBA, RN; Karen Landry, BS; and Richard S. Irwin, MD, Master FCCP; for the UMass Memorial Critical Care Operations Group

  • Study comparing clinical and financial outcomes pre- and post-teleICU support implementation, conducted from 2004 to 2013 (n=51,203)
  • Showed improvements in annual direct contribution margin (aggregated annual case revenue minus annual case direct costs, including operating costs of ICU telemedicine and related programs) from $7,921,584 (pre-ICU telemedicine) to $37,668,512 (ICU telemedicine) due to increased case volume, higher case revenue relative to direct costs, and shorter LOS.