Lehigh Valley Health Network Research Demonstrates Lifesaving Benefits of Advanced ICU, Telemedicine Care for Patients
Results are published in the latest edition of the Archives of Internal Medicine
Lehigh Valley, Pa. (April 19, 2010) - The value of telemedicine, the use of satellite technology, video conferencing and remote monitoring, to connect doctors and patients has lifesaving benefits. As shown in a new research study conducted by a team at Lehigh Valley Health Network (LVHN), Allentown, Pa., telemedicine, combined with 24/7 direct intensivist physician supervision, significantly lowers death rates by nearly 30 percent and decreases ventilator use in critically ill patients. This study involved critically ill patients who were cared for using Advanced Intensive Care Unit (AICU) technology along with remote monitoring by intensivists-certified critical care specialists.
Details of the study are published in the April 12, 2010 edition of the Archives of Internal Medicine. LVHN's research is important because it contrasts with previously published studies (published in JAMA) that concluded remote ICU telemonitoring made little or no difference in mortality and complication outcomes for patients.
The LVHN study, conducted at the 988-bed academic community hospital network (three hospitals and the remote monitoring unit) reports that the observed mortality rate for the group monitored by telemedicine and intensivists in the AICU was 29.5 percent lower than the control group, and ventilator use was decreased for the remotely monitored patients. The study looked at 954 patients (control group) who received care in the ICU for 16 months before implementation of AICU technology and remote intensivist coverage. The medical outcomes for those patients were then compared to the outcomes of 959 patients (intervention group) who received care for 10 months after the AICU and remote intensivist care began. The mortality for the control groups and intervention groups were 21.4 percent and 14.7 percent respectively, meaning one in every 14 patients who would have died, survived in the intervention group using telemedicine. That means that more than 60 patients in the study group who would have died, survived as a result of the intervention.
Matthew McCambridge, M.D., chief, LVHN's division of critical care medicine, says the results of the study are significant because caring for critically ill patients is complex, and there is an overall shortage of intensivist physicians. The results are telling because they show that by implementing AICU technologies and intensivist care, we are saving lives. We believe this model represents a significant advancement in the quality of critical care medicine."
Dr. McCambridge says the technology used for LVHN's research consisted of an ICU electronic medical record with a notification system for problems, computer-assisted physician order entry for ordering medications electronically, an electronic medication administration record, bar-coding for medication distribution, a picture archiving and communication system for x-rays, and an audio/visual remote monitoring system. The remote telemedicine team, which includes an intensivist physician and a critical care nurse, worked in conjunction with the caregivers in the hospital ICU and interacted with patients with real-time access to all necessary data.
Dr. McCambridge says the earlier research allowed a patient's physician to choose the degree to which the remote specialist would be involved in delivering direct care, while the LVHN study had all patients under the direct care of the intensivist physician both day and night.
We hope that these results will serve as evidence to encourage health care providers and others to invest in Advanced ICU technology and training of intensivist physicians to make a difference in the quality of patient care and save lives, Dr. McCambridge says.
Lehigh Valley Health Network includes three hospital facilities - two in Allentown and one in Bethlehem, Pa.; eight health centers caring for communities in four counties; numerous primary and specialty care physician practices throughout the region; pharmacy, imaging, home health services and lab services; and preferred provider services through Valley Preferred. Specialty care includes: trauma care at the region's busiest, most-experienced trauma center treating adults and children, burn care at the regional Burn Center, kidney and pancreas transplants; perinatal/neonatal, cardiac, cancer care, and neurology and complex neurosurgery capabilities including national certification as a Primary Stroke Center. Lehigh Valley Health Network is Network Cancer Program accredited, the highest available from the American College of Surgeons' Commission on Cancer; has been recognized by US News & World Report for 14 consecutive years as one of America's Best Hospitals; is a national Magnet hospital for excellence in nursing, and has been honored nine straight years among the top integrated health networks in the U.S. Additional information is available at lvhn.org and by following us on facebook.com/LVHealthNetwork and twitter.com/LVHNnews.
