Quantifying Telemedicine Intensive Care in the Veterans Health Administration (VHA)

• Activity Number: 308
• Type: Contributed
• Date/Time: Tuesday, August 11, 2015 : 8:30 AM to 10:20 AM
• Sponsor: Health Policy Statistics Section
• Author(s): Amy O'Shea* and Lynelle Johnson and Mary Vaughan Sarrazin and Peter Cram and Heather Schacht Reisinger
• Companies: Department of Veterans Affairs and VA Healthcare System of Ohio and CADRE, Iowa City VA Health Care System and University Health Network and Mount Sinai Hospital/University of Toronto and CADRE, Iowa City VA Health Care System
• Keywords: Intensive Care Unit ; Telemedicine ; Veterans Health Administration

Abstract

Healthcare systems increasingly use technology to improve patient care, but details of its use are often not considered in the improvement process. In August 2011 the VHA implemented a telemedicine intensive care unit (tele-ICU) initiative. Tele-ICU integrates on-site health care with remote monitoring by off-site intensivists and critical care nurses via video and audio telecommunications software. This study describes variations in use across two geographically distant Veterans Integrated Service Networks (VISN) using categorical data techniques and poisson regression. For 6,389 qualifying ICU admissions between October 1, 2012 and September 30, 2013, 1,608 standardized tele-ICU physician notes were linked to inpatient admission records. Physicians in these regions statistically differed (p< 0.05) in the use of professional communication; the communication initiator (bedside or tele-ICU staff); and documentation of routine, critical, or urgent interventions. It is clear tele-ICU utilization may vary by provider. Variations in use may impact efficacy assessments of tele-ICU programs in terms of quality measurement, execution, and measurable outcomes and should be considered.