-- Mary Elizabeth Dallas
MONDAY, May 16 (HealthDay News) -- Telemedicine -- the care of
patients by health care professionals located remotely -- may
benefit intensive care unit patients, new U.S. research shows.
ICUs that implemented a telemedicine intervention had lower
mortality rates, lower rates of preventable complications and
shorter hospital and ICU stays, according to researchers at the
University of Massachusetts Medical School in Worcester.
The study, slated for presentation Monday at a meeting of the
American Thoracic Society, is published online May 16 in the
Journal of the American Medical Association.
The research "provides important direction for how to best apply
telemedicine in intensive care," said Dr. Jeremy M. Kahn, of the
University of Pittsburgh, in an accompanying JAMA editorial.
Tele-ICU clinicians use audio, video and electronic links to
assist bedside caregivers in monitoring patients and to help direct
their care. In this study, health care professionals working
remotely monitored 6,290 adults admitted to ICUs at two campuses of
an academic medical centers from April 2005 to September 2007.
Among other things, the tele-ICU clinicians:
Researchers found the hospital mortality rate dropped from 13.6
percent to 11.8 percent once tele-ICU intervention was in
The ICU mortality rate fell from 10.7 percent to 8.6 percent for
the tele-ICU group. The length of a hospital stay declined from
13.3 days to 9.8 days in the tele-ICU group, while the length of an
ICU stay shrank from 6.4 days to 4.5 days.
Moreover, the study revealed that the tele-ICU intervention
period was associated with higher rates of adherence to best
clinical practices than the preintervention period for prevention
of deep vein thrombosis, stress ulcers and ventilator-associated
Lower rates of preventable complications were also noted for
ventilator-associated pneumonia and catheter-related blood stream
infection. In addition, best practice adherence for cardiovascular
protection was better in the tele-ICU period, the researchers
The results were similar for medical, surgical, and
Patients in the tele-ICU group were also 8 percent more likely
to go home, 6 percent less likely to go to a rehabilitation or
long-term care facility, and 2 percent more likely to go to a
skilled nursing facility than patients in the traditional ICU
As patient needs and the costs associated with adult critical
care have increased, more efficient methods of delivery of care,
such as tele-ICUs, are needed, the study authors said.
"Telemedicine alone does not equate to quality improvement but is merely a tool for quality improvement," Kahn said in an American Medical Association news release. "It is important to define specific quality deficiencies in the target ICUs, and then design the telemedicine intervention specifically to address those deficiencies, akin to other types of quality improvement."
The American Telemedicine Association has more information on
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