Cost benefit unclear on eICU systems

Remote ICU monitoring can cost hospitals $50,000 to $100,000 per bed, but it's not clear whether the tactic improves outcomes or can show a return on investment, according to a study published in the journal CHEST.

The study, lead by Gaurav Kumar, a fellow at the University of Iowa who is also affiliated with the Veterans Administration Medical Center in Iowa City, involved a review of eight studies, covering 29 ICUs and 26 hospitals.

He says about 40 U.S. hospitals have such setups. FierceHealthIT has reported on implementations at such hospitals as Providence Alaska Medical Center in Anchorage, Melrose-Wakefield Hospital in Melrose, Mass., and Evangelical Community Hospital in Lewisburg, Pa. The University of California-San Diego Medical Center recently teamed with nearby Tri-City Medical Center to bring telehealth into the hospital's neo-natal ICU unit.

The hospitals in seven of the studies Kumar's group reviewed had no intensive-care specialists on staff; four were tied to tele-ICU commercial vendors. And only five studies used real-time videoconferencing and 24-hour monitoring, reports Reuters.

Kumar's cost estimate covers the first year of  use. At the Iowa VA hospital and six others, the cost ran $70,000 to $87,000 per ICU bed per year. 

The reported savings, though, varied widely. Three vendor-sponsored studies reported profits up to $4,000 per patient. One reported a 30 percent decrease in time patients spend in the ICU. Two studies not affiliated with vendors found either no savings or increased costs.

In his next study, Kumar plans to look at outcomes and adherence to evidence-based practices for eICU care.

A cost of $70,000 a year works out to a little less than $200 per day per bed, he noted, which might be easily recouped through shorter patient stays or reduced complications.

"For tele-ICU programs to be sustainable over the long term, hospital administrators will demand rigorous financial analyses of budgetary impact," the authors wrote. "Long-term viability of tele-ICU programs will require more detailed data that these programs are cost-effective."

Of course, there's the issue of what to do when the ICU is full. A recent Canadian study found that a full ICU can prompt physicians to expedite end-of-life decision-making for patients too sick to benefit from it.

To learn more:
- read the abstract
- here's the Reuters article

 

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