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Comparing Intensive Care Unit (ICU) Telemedicine in the Veterans Health Administration
O'Shea AM, Vaughan-Sarrazin MS, Reisinger HS. Comparing Intensive Care Unit (ICU) Telemedicine in the Veterans Health Administration. Paper presented at: Joint Statistical Annual Meeting; 2016 Aug 2; Chicago, IL.
In August 2011 the VHA implemented an ICU telemedicine program that integrated remote monitoring by off-site intensivists and critical care nurses with on-site health care staff. Variability in staffing and protocols for use across sites complicates statistical comparison and program assessment. This study compares communication patterns between two ICU telemedicine programs that support 12 ICUs in the VA. Communication patterns were derived from a clinical note template recorded by the teleintensivist. From October 2012 through June 2014, 2,797 (15.7%) unique patient admissions had at least one interaction with an ICU telemedicine support center. Communications in the two programs statistically differed (p < .05) in initiation site (i.e., initiated by ICU or ICU telemedicine support center), primary site initiator (attending physician, nurse, and resident), and communication type (routine, urgent). Variations in use and the choices we make to standardize site data impact statistical analysis, as well as assessment and comparison of ICU telemedicine programs and should be considered.