Tele-ICU slashes mortality rates, speeds discharges for hospitals
Intensive care unit telehealth technology helped to improve survival rates of ICU patients and speed both ICU and hospital discharges, according to research published Thursday in CHEST Journal.
For the study, Craig Lilly, Director of the eICU Program at Worcester, Mass.-based UMass Memorial Medical Center, and a team of researchers examined the impact of tele-ICU technology across 56 intensive care units, 32 hospitals and 19 health systems over a five-year period. Overall, they found that patients who were cared for by hospitals that used the technology were 26 percent more likely than those that received usual ICU care to survive the ICU; additionally such patients were 16 percent more likely to survive their hospitalization.
Discharge rates also were faster at the ICU (20 percent) and hospital (15 percent) levels for those who received care at facilities utilizing tele-ICU technology. Care spanned close to 119,000 patients, overall.
"The findings were a little surprising because most interventions that dramatically reduce mortality increase length of stay, because the patients that survive are really sick and take a long time to get better," Lilly told FierceHealthIT in an exclusive interview. "That turned out not to be the case with this intervention primarily because it reduced complications. … This kind of an intervention is really different than a drug or a device in the sense that it can be different in different places."
According to Lilly, providers whose length of stay and mortality rates were reduced the most took advantage of technology's ability to allow critical care specialists to review patient cases within an hour of arrival. Additionally, Lilly said that hospitals that excelled at using their data in real time to correct mistakes benefited from the technology more than other hospitals.
"The technology itself isn't a substitute for doing the right things, which are getting a really good specialist in care and having doctors and nurses work together and use information to make their performance better," Lilly said. "But it really enabled people to do it. People that weren't doing it before that had been trying really hard, when they brought this technology in, on average, they were able to get it to work."
The New England Healthcare Institute (NEHI) last month published best practices for making tele-ICU more scalable and accessible to more hospitals and more beds. In its publication, NEHI said that tele-ICU appears to be entering a second phase marked by more diversity in practices and more experimentation.
Noting a number of hospitals that adopted tele-ICUs, but later dropped them, a New York Times article earlier this year questioned whether eICUs actually improve care for patients or the bottom line for hospitals.
To learn more:
- here's the CHEST Journal study abstract
NEHI offers best practices for tele-ICU's second phase
Hospital saw deaths, code blues and length of stays rise with telehealth use
Are eICUs as efficient as some studies portray?
Tele-ICU guidelines developed for critical care nurses
High costs force health system to drop eICU program