Intensive care unit robotic telepresence facilitates rapid physician response to unstable patients and decreased cost in neurointensive care.
BACKGROUND
The timely assessment and treatment of ICU patients is important for neurosurgeons and neurointensivists. We hypothesized that the use of RTP can improve physician rapid response to unstable ICU patients.


METHODS
This is a prospective study using a before-after, cohort-control design to test the effectiveness of RTP. Physicians used RTP to make rounds in the ICU in response to nursing pages. Data concerning several aspects of the RTP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RTP were documented. The effect of RTP on ICU length of stay and cost was assessed.


RESULTS
The use of RTP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RTP: 9.2 +/- 9.3 minutes vs conventional: 218 +/- 186 minutes). The response latencies to brain ischemia (7.8 +/- 2.8 vs 152 +/- 85 minutes) and elevated ICP (11 +/- 14 vs 108 +/- 55 minutes) were reduced (P < .001), as was the LOS for patients with SAH (2 days) and brain trauma (1 day). There was an increase in ICU occupancy by 11% compared with the prerobot era, and there was an ICU cost savings of $1.1 million attributable to the use of RTP.


CONCLUSIONS
The use of RTP enabled rapid face-to-face attending physician response to ICU patients and resulted in decreased ICU cost and LOS.
Vespa
Paul M
PM
Departments of Surgery/Neurological Surgery and Neurology, David Geffen School of Medicine at UCLA, University of California-Los Angeles, Los Angeles, CA 90095, USA. pvespa@mednet.ucla.edu
Miller
Chad
C
Hu
Xiao
X
Nenov
Val
V
Buxey
Farzad
F
Martin
Neil A
NA
D000328:Adult; D001927:Brain Diseases / Q000175:diagnosis* / Q000628:therapy*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics*; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010865:Pilot Projects; D019114:Remote Consultation / Q000191:economics / Q000379:methods*; D015203:Reproducibility of Results; D012371:Robotics; D013997:Time Factors