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Original Research: Critical Care |

The Costs of Critical Care Telemedicine ProgramsThe Costs of Critical Care Telemedicine Programs: A Systematic Review and Analysis

Gaurav Kumar, MD; Derik M. Falk, MD; Robert S. Bonello, MD; Jeremy M. Kahn, MD; Eli Perencevich, MD; Peter Cram, MD, MBA
Author and Funding Information

From the Division of Pulmonary, Critical Care, and Occupational Health (Drs Kumar and Falk) and the Division of General Internal Medicine (Drs Perencevich and Cram), Department of Internal Medicine, University of Iowa Carver College of Medicine; the Center for Comprehensive Access and Delivery Research and Evaluation (Drs Kumar, Perencevich, and Cram), Iowa City Veterans Affairs Medical Center, Iowa City, IA; the Minneapolis Veterans Affairs Medical Center (Dr Bonello), Minneapolis, MN; and the Program on Critical Care Health Policy and Management (Dr Kahn), Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.

Correspondence to: Gaurav Kumar, MD, Division of Pulmonary, Critical Care, and Occupational Health, University of Iowa, Carver College of Medicine, C33GH, 200 Hawkins Dr, Iowa City, IA 52242; e-mail: gaurav-kumar@uiowa.edu


For editorial comment see page 7

Funding/Support: Supported by the Veterans Affairs Health Services Research & Development [Grant IIR 09-099] (Dr Perencevich); in-kind research support in the form of data from the Cerner Corp (Kansas City, MO) and the National Institutes of Health career development award [K23HL082650] (Dr Kahn); a K23 career development award [RR01997201] from the National Center for Research Resources at the National Institutes of Health and the Robert Wood Johnson Physician Faculty Scholars Program (Dr Cram); and the Department of Veterans Affairs (Drs Perencevich and Cram). This work is also funded by a VA Merit Award [I01 HX000261].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(1):19-29. doi:10.1378/chest.11-3031
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Background:  Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals.

Methods:  We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature.

Results:  Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied.

Conclusions:  The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology.

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