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Original Research: Critical Care Medicine |

ICU Telemedicine Program Financial Outcomes

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

FUNDING SUPPORT: The authors have reported to CHEST that no funding was received for this study.

aDepartment of Medicine, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA

bDepartment of Anesthesiology and Surgery, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA

cClinical and Population Health Research Program, UMass Memorial Medical Center, Worcester, MA

dGraduate School of Biomedical Sciences, UMass Memorial Medical Center, Worcester, MA

eUMass Memorial Health Care, UMass Memorial Medical Center, Worcester, MA

fGraduate School of Nursing Sciences, UMass Memorial Medical Center, Worcester, MA

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

CORRESPONDENCE TO: Craig M. Lilly, MD, FCCP, Department of Anesthesiology and Surgery, University of Massachusetts Medical School, UMass Memorial Medical Center, 281 Lincoln St, Worcester, MA 01605


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


Chest. 2017;151(2):286-297. doi:10.1016/j.chest.2016.11.029
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Background  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 ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge.

Methods  Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across three groups that differed regarding telemedicine support: a group without ICU telemedicine support (pre-ICU intervention group), a group with ICU telemedicine support (ICU telemedicine group), and an ICU telemedicine group with added logistic 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 Health-Care Facilities.

Results  Annual case volume increased from 4,752 (pre-ICU telemedicine) to 5,735 (ICU telemedicine) and 6,581 (logistic center). The 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.

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 margins suggests that there is a financial argument to encourage the wider adoption of ICU telemedicine.

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