The introduction of telemedicine infectious disease consults produced positive results at a remote hospital, reducing patient transfers and lengths of stay, researchers reported in Clinical Infectious Diseases.
“Given the drive for health care institutions to increase access to care as well as reduce costs, telemedicine services provide a growth opportunity for ID clinicians,” Daniel H. Monkowski, MD, an ID physician in the Lehigh Valley Health Network in Allentown, Pennsylvania, and colleagues wrote. “We therefore sought to obtain a baseline and trends regarding the use of telemedicine consults as an adjunct to the standard of care at an institution where ID consultations were not previously available.”
Monkowski and colleagues retrospectively reviewed electronic medical records data to evaluate the implementation of telemedicine ID (teleID) consults at a 150-bed remote hospital. The primary outcomes included length of stay, antibiotic use and incidence of relapse.
At the remote hospital, 244 adult patients aged 18 years or older were provided with ID consultation either in-person or via teleID, or both. The pre-teleID group included 73 patients who received ID consultations from Jan. 19, 2011, to Feb. 1, 2013, whereas the teleID group included 171 patients who received consultations through a clinical telemedicine assessment between Feb. 5, 2013, and Feb. 24, 2014.
The researchers reported that all of the patients in the pre-teleID group were transferred from the remote hospital, whereas only 8.2% of patients in the teleID group were transferred. According to the study, length of stay decreased from a median of 14 days for patients in the pre-teleID group, to a median of 9 days for those seen via teleID (P = .0001).
Although Monkowski and colleagues observed a decrease in the duration of antibiotic treatment in the teleID group, it was not statistically significant. Furthermore, there was no statistically significant difference in relapse rates between the groups, but the researchers pointed to lack of data due to patients being lost to follow-up as a potential reason for this.
“Inpatient teleID consults serve as a useful form of ID consultation when access to ID care is otherwise limited. They allow patients to stay in their own community to receive expert care, reducing the cost and burden of travel for the patients and families,” Monkowski and colleagues wrote.
“They also contribute to improved antibiotic stewardship, by providing guidance about narrowing spectrum of action and duration of therapy. Overall, ID telemedicine consultation at a remote acute care hospital is a win for all involved.” – by Marley Ghizzone
Disclosures: The authors report no relevant financial disclosures.