TeleCare in the ICU

Despite all the money we spend on health care in this country, there are often shortages of critical physician expertise and effort is being devoted to finding methods to maximize the capacity of this expertise.  One such area is in the intensive care unit, where very sick patients require constant monitoring and attention.  There are six millions patients a year who utilize an ICU, with the highest costs and mortality of any patient group.  These ICU stays cost about $107 billion a year, a substantial fraction of the nation’s total health spending.

The number of doctors capable of managing these patients is not sufficient for the needs of most hospitals.  One solution has been to create the capability for physicians to remotely be able to monitor the equipment connected to a patient in real-time and to view other information feeds and then be able to modify orders or request additional tests.  The physicians can be in one place and manage patients in several ICUs in this manner.    A New England Healthcare Institute report describes and studies one such set-up in Massachusetts.   (NEHI Report)

Doctors at the University of Massachusetts hospital, an academic medical center, created an electronic command post from which they could track patients both at their home hospital’s ICU and at patients in two community hospitals.  Following implementation of this approach, mortality rates int he ICU declined by over 20% and length of stay in the ICU also declined.  Even one day less in an ICU can mean very significant savings.  The cost of setting up the system and its ongoing operation were paid back in about a year from the cost savings.  The authors extrapolated these results to conclude that in Massachusetts alone $120 million could be saved from wider use of tele-ICU.