title: Impact of an intensive care unit telemedicine program on a rural health care system.
abstract: We evaluated the impact of a 15-hospital, rural, multi-state intensive care unit (ICU) telemedicine program. Acute Physiology, Age, and Chronic Health Evaluation (APACHE III) scores, raw mortality rates, and actual-to-predicted length of stay (LOS) ratios and mortality ratios were used. Surveys evaluated program impact in smaller facilities and satisfaction of the physicians staffing the remote center. Smaller facilities' staff reported improvements in the quality of critical care services and reduced transfers. In regional hospitals, acuity scores increased (retention of sicker patients) while raw mortality was the same or lower. Length of stay ratios were reduced in these hospitals. In the tertiary hospital, actual-to-predicted ICU and hospital mortality and LOS ratios decreased.
authors.affiliation: Avera eICU CARE, Sioux Falls, SD 57105, USA. ezawada@sio.midco.net
authors.forename: Edward T
authors.initials: ET
authors.lastname: Zawada
authors.forename: Patricia
authors.initials: P
authors.lastname: Herr
authors.forename: Deanna
authors.initials: D
authors.lastname: Larson
authors.forename: Robert
authors.initials: R
authors.lastname: Fromm
authors.forename: David
authors.initials: D
authors.lastname: Kapaska
authors.forename: David
authors.initials: D
authors.lastname: Erickson
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D015397:Program Evaluation / Q000379:methods*; D012189:Retrospective Studies; D019035:Rural Health Services / Q000458:organization & administration*; D017216:Telemedicine / Q000458:organization & administration*; D013997:Time Factors; D014481:United States