ICU administration · Telemedicine in intensive care
Telemedicine for remote monitoring of intensive care patients
| Design | Multicentre before-and-after study |
|---|---|
| Treatment | Remote telemedicine monitoring of ICU patients |
| Control | Pre-intervention period |
| Population | 4142 patients — 2034 before and 2108 after the intervention; full treatment authority was delegated to the tele-ICU for 655 (31.1%) of the post-intervention cohort |
| Follow-up | Hospital discharge |
| Primary endpoint | Hospital mortality and length of stay |
| Result | Local physicians delegated full treatment authority to the tele-ICU for 655 patients (31.1%) and authority to intervene only in life-threatening events for the remainder. Remote monitoring was not associated with an overall improvement in mortality or length of stay. |
| Secondary endpoints | Complications, ICU length of stay |
Remote monitoring of ICU patients was not associated with an overall improvement in mortality or LOS.
The trial authors, in the published abstract
The delegation figure explains a great deal: for two thirds of patients the tele-ICU could only intervene in emergencies. Telemedicine without authority to act is surveillance, not care — and the contrast with Lilly 2011 suggests the process change is what carries any benefit.
Thomas EJ, Lucke JF, Wueste L, et al. Association of telemedicine for remote monitoring of intensive care patients with mortality, complications, and length of stay. JAMA 2009 Dec 23;302(24):2671-8.