Robotic remote presence technology in the surgical intensive care unit.
BACKGROUND
A national shortage of intensivists coupled with an increased demand for 24/7 intensive care unit (ICU) attending coverage poses staffing problems. To extend physician availability, many institutions have adopted varying forms of remote presence technology (RPT). The authors examine their experience with robotic technology to extend physician presence.


METHODS
The RP-7 experience (InTouch Health, Santa Barbara, CA) was examined from March 1, 2008, to December 31, 2010. Intensivists were on site daily from 8:00 AM to 5:00 PM. Evening rounds were conducted by either RP-7 or telephone. Data were acquired after each session and included demographic data, patients evaluated, interventions made, nighttime discussions regarding plan of care, signal drops, time spent, subsequent calls, unexpected events, and a user evaluation. In addition, Acute Physiology and Chronic Health Evaluation II data, length of stay (LOS), and mortality data were tracked for each group. Data are presented as mean ± standard deviation. Statistical analysis was done using Student's t test.


RESULTS
The two groups did not differ in regard to age, Acute Physiology and Chronic Health Evaluation II score, or mortality. The RP-7 group demonstrated a decreased hospital and ICU LOS and less subsequent unexpected events. RPT rounds were longer, resulted in more interventions, intensivists received less subsequent calls, and users reported a higher rate of satisfaction with RP-7.


CONCLUSIONS
Communication between attending physician and staff is enhanced by RPT. In addition, hospital and ICU LOS are improved with RPT. Although the two groups do not differ in mortality, improved patient safety was inferred by the decreased number of untoward events.
Department of Surgery, Winthrop University Hospital, State University of New York at Stony Brook, Mineola, NY 11501, USA. jmcnelis@optonline.net
John
J
McNelis
Garry J
GJ
Schwall
John F
JF
Collins
D018806:APACHE; D003142:Communication; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D019114:Remote Consultation / Q000295:instrumentation*; D012189:Retrospective Studies; D012371:Robotics / Q000295:instrumentation*; D016896:Treatment Outcome; D000078329:Workforce