Balancing cost issues
Cost issues with the tele-ICU have been a barrier for widespread adoption, Dr. Udeh said. He estimated that only about 15%-20% of hospitals incorporate the model.
Hospitals must pay for hardware and the telehealth service while still needing to have someone on staff available to come in if a physician’s presence is needed. And so far, those costs are not generally reimbursable by payers.
Hospitals must balance the costs with the potential for better outcomes and shorter stays, he said.
The model has benefits for the provider as well.
Dr. Udeh recounted being awakened by a call in the middle of the night and fighting off grogginess to quickly process information and make critical decisions.
But with the tele-ICU model, providers are awake for a specified shift and are periodically rounding on patients electronically with real-time access to health information.
Dr. Udeh said many of the tele-ICU platforms have decision support built in, with various degrees of complexity, so that the system might flag when a patient’s blood pressure is trending down, for example.
Although this research used prepandemic data, COVID-19 has highlighted the need for solutions to stretch ICU workforces.
Dr. Scott pointed out that in the pandemic, many hospitals that don’t have regular critical care services have had to take care of critically ill patients.
Having a telemedicine program can help bring that expertise to the bedside, he said.
Dr. Udeh, his coinvestigators, and Dr. Scott have disclosed no relevant financial relationships.
A version of this article first appeared on.