VA ICU telemedicine intervention has no impact on mortality, length of stay

An intensive care unit (ICU) telemedicine intervention program at eight Department of Veterans Affairs (VA) hospitals made no impact on reducing patient mortality rates or length of stay, according to a study appearing in JAMA Internal Medicine.

The observational pre-post study examined patients treated between 2011 and 2012 in the VA hospitals that implemented telemedicine monitoring during the post-telemedicine period as well as patients treated in concurrent control ICUs that did not implement a telemedicine program.

Researchers assessed unadjusted and risk-adjusted ICU, in hospital and 30-day mortality rates and ICU and hospital length of stay for patients who did or did not receive treatment in ICUs equipped with telemedicine monitoring. In all, the study included 3,355 patients treated in the telemedine ICU intervention, with 1,708 in the pre-telemedicine period and 1,647 in the post-telemedicine period), as well as 3,585 patients treated in the control ICUs during the same timeframe.

“We found no evidence that the implementation of ICU telemedicine significantly reduced mortality rates or length of stay,” concluded lead author Boulos S. Nassar, MD, MPH, of the Iowa City VA Health Care System, and colleagues.

Specifically, unadjusted ICU mortality in the pre-telemedicine versus post-telemedicine periods were 2.9 percent versus 2.8 percent for the intervention ICUs and 4.0 percent versus 3.4 percent for the control ICUs. Moreover, the unadjusted 30-day mortality during the pre-telemedicine versus post-telemedicine periods were 7.7 percent versus 7.8 percent for the intervention ICUs and 12.0 percent versus 10.2 percent for the control ICUs, the researchers found.