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Original Research |

ICU Telemedicine Program Financial Outcomes

Craig M. Lilly, MD; Christine Motzkus, MPH; Teresa Rincon, RN, BSN; Shawn E. Cody, PhD, MSN/MBA, RN; Karen Landry, BS; Richard S. Irwin, MD
Author and Funding Information

COI: None of the authors has received anything of value from any commercial entity relative to the content of this presentation.

aDepartments of Medicine

bAnesthesiology, and Surgery, University of Massachusetts Medical School, Worcester, MA

cClinical and Population Health Research Program

dGraduate School of Biomedical Sciences

eUMass Memorial Health Care

gGraduate School of Nursing Sciences

fDepartment of Nursing, UMass Memorial Medical Center, Worcester, MA

Corresponding Author: Craig M. Lilly, MD, Professor of Medicine, Anesthesiology, and Surgery, University of Massachusetts Medical School, UMass Memorial Medical Center, 281 Lincoln Street, Worcester, MA 01605.


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.11.029
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Abstract

Background  Intensive care unit (ICU) telemedicine improves access to high quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following tele-ICU implementation and after the addition of logistic center function has not been published.

Methods  Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across 3 groups that differed with regard to telemedicine support: a group without tele-ICU support (Pre-ICU intervention group), a group with tele-ICU support (ICU Telemedicine group) and a tele-ICU group with added logistical center functions and support for quality care standardization (Logistic Center Group). The primary outcome was annual direct contribution margin defined as aggregated annual case revenue minus annual case direct costs (including operating costs of ICU telemedicine and its related programs). All monetary values were adjusted to 2015 US dollars, using producer price index for healthcare facilities.

Results  Annual case volume increased from 4,752 (Pre-ICU Telemedicine) to 5,735 (ICU Telemedicine) and 6,581 (Logistic Center). Annual direct contribution margin improved from $7,921,584 (Pre-ICU Telemedicine) to $37,668,512 (ICU Telemedicine) to $60,586,397 (Logistic Center) due to increased case volume, higher case revenue relative to direct costs, and shorter length of stay (LOS).

Conclusions  The ability of properly modified ICU telemedicine programs to increase case volume and access to high quality critical care with improved annual direct contribution margin suggests that there is a financial argument to encourage the wider adoption of ICU telemedicine.


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