Intensive care unit robotic telepresence facilitates rapid physician response to unstable patients and decreased cost in neurointensive care

被引:84
作者
Vespa, Paul M.
Miller, Chad
Hu, Xiao
Nenov, Val
Buxey, Farzad
Martin, Neil A.
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg Neurol Surg, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA
来源
SURGICAL NEUROLOGY | 2007年 / 67卷 / 04期
关键词
intensive care; telemedicine; telepresence; brain trauma; subarachnoid hemorrhage; stroke; intracerebral hemorrhage; length of stay; hospital cost; robotics;
D O I
10.1016/j.surneu.2006.12.042
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: The timely assessment and treatment of ICU patients is important for neurosurgeons and neurointensivists. We hypothesized that the use of RTP can improve physician rapid response to unstable ICU patients. Methods: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RTP. Physicians used RTP to make rounds in the ICU in response to nursing pages. Data concerning several aspects of the RTP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RTP were documented. The effect of RTP on ICU length of stay and cost was assessed. Results: The use of RTP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RTP: 9.2 +/- 9.3 minutes vs conventional: 218 +/- 186 minutes). The response latencies to brain ischemia (7.8 +/- 2.8 vs 152 +/- 85 minutes) and elevated ICP (I I +/- 14 vs 108 +/- 55 minutes) were reduced (P < .001), as was the LOS for patients with SAH (2 days) and brain trauma (I day). There was an increase in ICU occupancy by 11% compared with the prerobot era, and there was an ICU cost savings of $1.1 million attributable to the use of RTP. Conclusion: The use of RTP enabled rapid face-to-face attending physician response to ICU patients and resulted in decreased ICU cost and LOS. (c) 2007 Elsevier Inc. All rights reserved.
引用
收藏
页码:331 / 337
页数:7
相关论文
共 11 条
  • [1] Critical care delivery in the United States: Distribution of services and compliance with Leapfrog recommendations
    Angus, DC
    Shorr, AF
    White, A
    Dremsizov, TT
    Schmitz, RJ
    Kelley, MA
    [J]. CRITICAL CARE MEDICINE, 2006, 34 (04) : 1016 - 1024
  • [2] Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease - Can we meet the requirements of an aging population?
    Angus, DC
    Kelley, MA
    Schmitz, RJ
    White, A
    Popovich, J
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 284 (21): : 2762 - 2770
  • [3] Comparison of tissue plasminogen activator administration management between telestroke network hospitals and academic stroke centers -: The Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany
    Audebert, Heinrich J.
    Kukla, Christian
    Vatankhah, Bijan
    Gotzler, Berthold
    Schenkel, Johannes
    Hofer, Stephan
    Fuerst, Andrea
    Haberl, Roman L.
    [J]. STROKE, 2006, 37 (07) : 1822 - 1827
  • [4] Effect of a multiple-site intensive care unit telemedicine program on clinical and economic outcomes: An alternative paradigm for intensivist staffing
    Breslow, MJ
    Rosenfeld, BA
    Doerfler, M
    Burke, G
    Yates, G
    Stone, DJ
    Tomaszewicz, P
    Hochman, R
    Plocher, DW
    [J]. CRITICAL CARE MEDICINE, 2004, 32 (01) : 31 - 38
  • [5] Milstein A, 2000, Eff Clin Pract, V3, P313
  • [6] Physician staffing patterns and clinical outcomes in critically ill patients - A systematic review
    Pronovost, PJ
    Angus, DC
    Dorman, T
    Robinson, KA
    Dremsizov, TT
    Young, TL
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (17): : 2151 - 2162
  • [7] Early goal-directed therapy in the treatment of severe sepsis and septic shock.
    Rivers, E
    Nguyen, B
    Havstad, S
    Ressler, J
    Muzzin, A
    Knoblich, B
    Peterson, E
    Tomlanovich, M
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (19) : 1368 - 1377
  • [8] Intensive care unit telemedicine: Alternate paradigm for providing continuous intensivist care
    Rosenfeld, BA
    Dorman, T
    Breslow, MJ
    Pronovost, P
    Jenckes, M
    Zhang, N
    Anderson, G
    Rubin, H
    [J]. CRITICAL CARE MEDICINE, 2000, 28 (12) : 3925 - 3931
  • [9] The implications of cerebral ischemia and metabolic dysfunction for treatment strategies in neurointensive care
    Vespa, Paul M.
    [J]. CURRENT OPINION IN CRITICAL CARE, 2006, 12 (02) : 119 - 123
  • [10] Multimodality monitoring and telemonitoring in neurocritical care: from microdialysis to robotic telepresence
    Vespa, PM
    [J]. CURRENT OPINION IN CRITICAL CARE, 2005, 11 (02) : 133 - 138