Telehealth services used in intensive care units are associated with lower mortality rates and shorter hospital stays, according to a study published in the Journal of the American Medical Association, HealthDay reports (Dallas, HealthDay, 5/16).
The study was conducted at the University of Massachusetts Memorial Medical Center (Kowalczyk, "White Coat Notes," Boston Globe, 5/16). A telehealth program was implemented at seven ICUs at the center over the course of a year (Conn, Modern Healthcare, 5/17).
For the study, health care professionals working remotely monitored 6,290 patients in the ICUs between April 2005 and September 2007.
- Reviewed the care of individual patients;
- Studied adherence to best practice guidelines;
- Monitored responses to electronic alerts and alarms; and
- Intervened and initiated treatments if response time was too long or if patients appeared unstable (HealthDay, 5/16).
Researchers found that after implementing the telehealth program:
- Hospital mortality rates dropped from 13.6% to 11.8%;
- Patients' average length of hospital stay dropped from 13.3 days to 9.8 days (Smith, MedPage Today, 5/16);
- ICU mortality rates dropped from 10.7% to 8.6%; and
- Patients' average length of stay in the ICU dropped from 6.4 days to 4.5 days (HealthDay, 5/16).
In addition, the study found that after implementing the telehealth program, rates of adherence to best clinical practices increased and rates of preventable complications decreased (MedPage Today, 5/16).
Craig Lilly -- lead author of the study, and vice chair of critical care operations and director of the electronic ICU program at UMass Memorial Medical Center -- said the study is "a very, very strong clear signal" that telehealth technology is effective (Modern Healthcare, 5/17).
However, the researchers acknowledged that the telehealth program was implemented at a single institution and could be difficult to replicate (MedPage Today, 5/16).
In a related editorial also published in JAMA, Jeremy Kahn -- an associate professor of critical care and health policy at the University of Pittsburgh -- wrote that the study provides "the first convincing evidence that ICU telemedicine can be an effective complement to bedside care in some settings."
However, he added that the study leaves unanswered two key questions:
- Whether telehealth can improve care in rural and remote settings; and
- Whether patients would benefit as much if facilities hired additional on-site staff as they would under more expensive electronic ICUs ("White Coat Notes," Boston Globe, 5/16).