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Editorials: POINT/COUNTERPOINT EDITORIALS |

Point: Should Tele-ICU Services Be Eligible for Professional Fee Billing? Yes. Tele-ICUs and the Triple AimYes. Tele-ICUs and the Triple Aim

Matthew M. McCambridge, MD, FCCP; Joseph A. Tracy, MS; George A. Sample, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine (Dr McCambridge) and Division of Telehealth Services (Mr Tracy), Lehigh Valley Health Network, and Surgical Critical Care Services (Dr Sample), Washington Hospital Center.

Correspondence to: George A. Sample, MD, FCCP, Surgical Critical Care Services, Washington Hospital Center, 110 Irving St, NW, Ste 4B42, Washington, DC 20010; e-mail: george.a.sample@medstar.net


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr McCambridge is supported by the Dexter and Dorothy Baker Family Foundation. Dr Sample is a member of the American Medical Association CPT Advisory Committee, Society of Critical Care Medicine. The opinions expressed in this editorial are the personal opinions of Dr Sample and not necessarily those of the Society of Critical Care Medicine. Mr Tracy has reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(4):847-849. doi:10.1378/chest.11-1555
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Nearly 540,000 patients die in ICUs each year, and the total cost of ICU care in the United States exceeds $107 billion annually.1,2 Only 10% to 20% of hospitals have dedicated critical care staffing, and <1% have dedicated intensivists on site at night.3 By 2020, there will be a 35% shortage of intensivists.3-5 At the same time, research has shown that a dedicated, on-site intensivist managing or comanaging patients reduces length of stay (LOS) by 30% and ICU mortality by 40%.6 In the United States, this staffing model could save as many as 53,000 lives per year and $5.4 billion annually.7,8 The question is: How do we extend the limited supply of intensivists to provide better care for the increasing number of critically ill patients? The answer is clear: Expand the use of ICU telemedicine (tele-ICU) to address these shortages, lessen mortality, and improve outcomes while potentially decreasing ICU costs.2,9 The results of expanded access to critical care through tele-ICUs would be consistent with the goals of Donald Berwick’s “triple aim”: improved experience of care, improved health, and reduced per-capita costs.10

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