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O AM, Johnson L, Vaughan-Sarrazin MS, Cram PM, Reisinger HS. Quantifying Telemedicine Intensive Care in the Veterans Health Administration (VHA). Paper presented at: Joint Statistical Annual Meeting; 2015 Aug 8; Seattle, WA.
Healthcare systems increasingly use technology to improve patient care, but details of its use are often not considered in the improvement process. In August 2011 the VHA implemented a telemedicine intensive care unit (tele-ICU) initiative. Tele-ICU integrates on-site health care with remote monitoring by off-site intensivists and board-certified critical care nurses via video and audio telecommunications software. This study describes variations in use across two geographically distant Veterans Integrated Service Networks (VISN) using categorical data techniques. For 6,389 qualifying ICU admissions between October 1, 2012 and September 30, 2013, 1,608 standardized tele-ICU physician notes were linked to inpatient admission records. Physicians in these regions statistically differed (p < .05) in the use of professional communication; the communication initiator (bedside or tele-ICU staff); and documentation of routine, critical, or urgent interventions. It is clear that tele-ICU utilization may vary by provider. Variations in use may impact the assessment of the efficacy of tele-ICU programs in terms of quality measurement, execution, and measurable outcomes and should be considered.