Hospital saw deaths, code blues and length of stays rise with telehealth use

Patients in one hospital's intensive care units had slightly higher mortality rates and stayed slightly longer in the ICU after the hospital started using telemedicine monitoring tools, according to preliminary study results reported by MedPage Today.

None of the effects were statistically significant, study author Ajit Dhakal, M.D., of Northside Medical Center in Youngstown, Ohio, said in presenting the findings at the CHEST meeting in Chicago, according to the article. But, he said, the results were trending in the wrong direction.

The year-over-year mortality rate rose from 78 to 90 and the mean length of stay increased from 3 to 3.2 days. The rate of falls went from zero to 0.81, the study found, and the number of code blues rose from 39 to 54.

The acknowledged they worked with a relatively small sample size at the 375-bed hospital, where they looked at statistics from two adult ICUs.

Advocates of eICUs will have to demonstrate the technology shortens patient stays to win administrator support, Mira Loh-Trivedi, Pharm.D, of the ICU at Franciscan Alliance St. Margaret Health in Hammond, Ind., told MedPage Today.

"These kind(s) of technologies can stretch the current staff, but they themselves are expensive so you have to have a defensible endpoint [for] investing in that kind of technology," she said.

Cost has been an issue for a number of hospitals. This summer MaineHealth became one of the latest healthcare provider to end its eICU program, contending the hospital would run a $500,000 annual deficit if it continued the program. Part of the problem was that some insurers would not reimburse hospitals for telemonitoring costs.

And a New York Times article this spring questioned whether eICUs actually improve care for patients or the bottom line for hospitals. The article noted conflicting study results about mortality rates and the return on investment, and referenced a number of other hospitals that abandoned the technology.

For more information:
- read the MedPage Today article
- here's the New York Times article

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