Critical care telehealth shows its worth
Remote intensive care units lead to better survival rates and faster discharges, according to new research published by the American College of Chest Physicians.
The study, published Dec. 5 on the website of CHEST Journal, shows that eICUs have a key role to play in helping hospitals and health systems improve care and lower costs.
The research, which examined the impact of Philips' eICU Program on nearly 120,000 critical care patients across 56 intensive care units, 32 hospitals and 19 health systems over a five-year period, demonstrated reductions in both mortality and length of stay. The results were statistically significant on both an unadjusted and severity-adjusted basis, according to researchers.
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"This is the first large-scale study that ties ICU telehealth to both the improvement of patient outcomes and cost reduction through shorter length of stays in the ICU and hospital and identifies the processes that achieved greater efficiency," said Craig M. Lilly, MD, professor of medicine, anesthesiology and surgery at the University of Massachusetts Medical School and director of the eICU Program at UMass Memorial Medical Center, in a press statement.
"These results point to a significant opportunity to better manage and treat our critical patients in this time of increasing pressure from healthcare reform to deliver high quality and cost-effective care," he said.
For the study, participants from 19 healthcare systems using Philips' eICU program, which enables healthcare professionals from a centralized eICU to offer around-the-clock care for critically ill patients.
The eICU program utilizes bi-directional audio/video technology, population management tools, proprietary clinical decision support, real-time and retrospective reporting tools and targeted process redesign, according to Philips.
Research showed that, compared to patients receiving usual ICU care, those who were treated at a hospital that deployed the eICU program were:
- 26 percent more likely to survive the ICU;
- Discharged from the ICU 20 percent faster;
- 16 percent more likely to survive hospitalization and be discharged;
- Discharged from the hospital 15 percent faster.
[See also: Telehealth boosts ICU for rural hospitals.]
The Philips eICU program allows critical care teams of nurses and intensivist physicians, regardless of where they are, to gain instant and real-time access to information required to intervene proactively before complications develop, say Philips officials. These timely interventions can lead to reduced mortality and length of stay.
Hospitals and health systems that saw the largest reduction in length of stay and mortality rates were those that excelled in components of the program involving people, technology and processes, according to the study.
As a result, the research uncovered program design elements common to the most successful ICU telehealth programs, such as:
- Having an intensivist physician perform a remote review of the patient and care plan within one hour of ICU admission;
- Frequent collaborative review and use of performance data provided by the ICU telemedicine program;
- Faster response times to technology-based alerts and alarms for physiological and laboratory value instability;
- Increased rates of adherence to ICU best practices for those that are supported by the ICU telemedicine team;
- Interdisciplinary rounds;
- Institutional ICU committee effectiveness.
"Today, personnel accounts for 56 percent of the $2.8 trillion healthcare spend in the U.S., and coupled with the current shortage of clinicians, many hospitals are unable to offer on-site intensivist physicians, 24 hours a day, seven days a week," said Brian Rosenfeld, vice president and chief medical officer, Philips HealthcareTelehealth, in statement.
"This study provides further evidence that health systems employing coordinated telehealth in their care models will increase provider productivity, while improving outcomes and reducing costs."