title: Clinical and economic outcomes of the electronic intensive care unit: results from two community hospitals.
abstract: OBJECTIVE
  To determine the impact of a telemedicine system, the electronic intensive care unit (eICU), on ICU, and non-ICU mortality, total mortality, total and ICU-specific length of stay, and total hospital cost at two community hospitals.
  
  
  METHODS
  Observational study with one baseline period and two comparison periods (eICU wave one and eICU wave two). Each time period was 4 months in duration.
  
  
  METHODS
  Four ICU from two community hospitals in the metropolitan Chicago area. Hospital one is a 610-bed teaching hospital with three adult ICU (ten-bed medical ICU, ten-bed cardiac ICU, and 14-bed surgical ICU). Hospital two is a 185-bed nonteaching hospital with a ten-bed mixed medical/surgical ICU.
  
  
  METHODS
  All patients 18 yrs or older with an ICU stay of at least 4 hrs during the specified time period were included.
  
  
  METHODS
  The eICU was implemented at both hospitals in April 2003.
  
  
  RESULTS
  Mortality, length of stay, and total cost were measured. Age, gender, race/ethnicity, trauma status, Acute Physiology and Chronic Health Evaluation III score, and physician utilization of the eICU were included as covariates.Included in the analysis were 4088 patients (1371 at baseline, 1287 in eICU wave one, and 1430 in eICU wave two). The eICU did not have a significant effect on ICU/non-ICU/total mortality or hospital length of stay. ICU length of stay increased over time and was associated with higher physician utilization of the eICU. Although total hospital costs increased over time, the rate of increase was steeper for those patients whose physicians permitted only a low level of eICU involvement.
  
  
  CONCLUSIONS
  In our study of >4000 patients representing two community hospitals, we did not find a reduction in mortality, length of stay, or hospital cost attributable to the introduction of the eICU.
authors.affiliation: Advocate Lutheran General Hospital, Park Ridge, IL, USA. jeanette.morrison@rosalindfranklin.edu
authors.forename: Jeanette L
authors.initials: JL
authors.lastname: Morrison
authors.forename: Qian
authors.initials: Q
authors.lastname: Cai
authors.forename: Nancy
authors.initials: N
authors.lastname: Davis
authors.forename: Yan
authors.initials: Y
authors.lastname: Yan
authors.forename: Michael L
authors.initials: ML
authors.lastname: Berbaum
authors.forename: Michael
authors.initials: M
authors.lastname: Ries
authors.forename: Glen
authors.initials: G
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality / Q000639:trends*; D006764:Hospitals, Community / Q000191:economics* / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000191:economics; D011336:Probability; D017216:Telemedicine / Q000191:economics*; D014481:United States