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Remote monitoring of ICU patients lowers mortality rates, complications

"Of five million adults admitted to ICUs each year, 70 to 90 percent are not being managed by a critical care team." Todd Dorman, M.D.

American hospitals with a shortage of "intensivists" to treat patients in their intensive care units (ICUs) could benefit from having such experts monitor their patients offsite via computer, Johns Hopkins researchers have found.

In a pilot telemedicine study, four of these critical care specialists monitored the 10-bed surgical ICU of an academic-affiliated community hospital without a full-time specialist in house. Death rates dropped up to 68 percent, complications by up to 50 percent, length of stay by up to 34 percent and costs by up to 36 percent. Results were published in a recent issue of the journal Critical Care Medicine.

In the United States, only 50 percent of hospitals have intensivists available, and most are on a limited consulting basis. To staff every ICU sufficiently would require 35,000 to 40,000 of these specialists, says Todd Dorman, M.D., an author of the paper and an associate professor of anesthesiology and critical care medicine at Hopkins. Currently, there are less than 10,000.

"This isn't designed to be a replacement of full-time staff, but an extension," Dorman says. "It's a way to better leverage critical care expertise among smaller institutions that don't have the resources to hire people.

"Of five million adults admitted to ICUs each year, 70 to 90 percent are not being managed by a critical care team. The problem is two-fold: First, people are living longer and therefore have concomitant illnesses. Second, we have less reserve to handle the overflow in the ICUs. Our study shows that remote care programs may provide a means of improving quality of care and reducing costs when on-site intensivist coverage is not available."

Many hospitals can't afford critical care coverage 24 hours a day, seven days a week, Dorman says, and for those with only a handful of ICU beds,
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Contact: Karen Blum
kblum@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
19-Mar-2001


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