Massachusetts researchers have found an association between using telecommunication technology in a hospital's intensive-care units with improved patient outcomes and better adherence to clinical best practices, according to a report on their study published in the Journal of the American Medical Association.
The study, conducted under the auspices of the University of Massachusetts Medical School, covered the period from late April 2005 to September 2007 and looked at the experiences of 6,290 adult patients admitted to seven intensive-care units at an unnamed 834-bed academic medical center. The tele-ICU system was rolled out at the seven ICU care sites with staggered implementation dates over the period of a year, letting the researchers compare results for a "preintervention group" of patients admitted to intensive care before tele-ICU was provided to that unit and a group of patients admitted after telehealth services were being used.
The researchers looked for differences in risk-adjusted mortality rates, lengths of stay and other outcomes, including compliance with a predefined set of best practices for several conditions. The results showed a hospital mortality rate of 13.6% during the preintervention period, compared with 11.8% after deployment of the tele-ICU system. Adherence to best practices was higher during the tele-ICU period than during the preintervention period for deep-vein thrombosis, 99% vs. 85% and stress ulcer prevention, 96% vs. 83%, for example; and the study also found improved numbers for several other quality and patient-safety outcomes such as lower rates of preventable complications (ventilator-associated pneumonia, 0.6% with tele-ICU, 1.0% without it.)