Patients receiving ICU services via telehealth spend less time in hospital

Patients in the ICU who received care from a teleintensivist were less likely to die and more likely to be discharged sooner than those who received traditional ICU care, data show.

Researchers said teleintensivists can help identify health issues earlier and move care along more quickly. They can also potentially work overnight, covering several ICUs and allowing the daytime intensivist to get more uninterrupted sleep, reducing the likelihood of physician burnout, according to Chiedozie I. Udeh MD, MHEcon, MBA, an intensivist at Cleveland Clinic Foundation and coauthor of the study.

“In an ideal world, patients would have an intensivist at the bedside 24/7, but the reality is that even if we had all of the money in the world, we don’t have enough trained professionals to do the job,” Udeh said in a press release.

ICU-telehealth is estimated to be available at about 15% to 20% of U.S. hospitals, according to the release. It is more often used in larger health systems.

Teleintensivists perform ICU-telehealth by monitoring dashboards of patients at various hospitals, keeping an eye on patients’ vital statistics and calling for the patient’s medical records, if needed. The intensivist, a bedside nurse and a patient can simultaneously see and talk to each other via two-way communication. The dashboard’s software “typically” includes tools that help the teleintensivist determine which patients are sicker or deteriorating, allowing the teleintensivist to “proactively intervene when appropriate,” the press release said. In some health systems, the teleintensivist is on call and steps in to help when situations warrant it.

The study by Udeh and colleagues, which was presented during the Society for Critical Care Medicine’s Critical Care Congress, included data from 153,987 patients who received ICU care at one of nine Cleveland Clinic hospitals between Jan. 1, 2010, and Dec. 31, 2019. According to the release, 70% of the patients received ICU-telehealth care during hours when an intensivist was not on site. Udeh and colleagues found that patients who received ICU-telehealth care were about 18% less likely to die and spent 1.6 fewer days in the ICU and 2.1 fewer days in the hospital. In addition, patients who were admitted on a weekend were no more likely to die than those who were admitted on a weekday.

The COVID-19 pandemic has highlighted the importance of the study findings, according to Udeh.

“The demand for critical care has been growing as the population ages and COVID-19 has exacerbated that need,” he said. “The value of ICU-telemedicine has become even more clear during the pandemic, including providing the ability to extend care when the ICU reaches capacity and staff levels are stretched.”