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Virtual ICUs: Big Investment, Bigger Returns

Gienna Shaw, for HealthLeaders Media, September 15, 2010
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Editor's note: This is the third in a three-part series on how technology impacts the cost of healthcare.
The July and August articles focused on imaging technology and cancer treatments, respectively.

In many industries, new technologies often drive costs down (self-service kiosks now common in airports, for example). In healthcare, however, new and improved technologies usually drive up costs. Worse, there's often scant proof that the latest iteration of any given technology significantly improves outcomes.

One striking example: Nuclear particle accelerators used for proton beam therapy can cost hundreds of millions of dollars. But a report published by the National Cancer Institute in March found no evidence that they provide better outcomes or result in fewer side effects than traditional photon radiation.

About a year ago, a study in the Journal of the American Medical Association raised similar questions about the growing field of remote intensive care unit monitoring using systems such as Netherlands-based Philips' Visicu eICU. The authors of the JAMA study said they found "no association between implementation of telemedicine technology and adjusted hospital or ICU mortality, [length of stay], or complications." 

And virtual ICU systems are expensive. The cost—which includes software, hardware, two-way video and audio equipment, clinical salaries, and licensing fees—varies depending on the number of beds monitored, but can easily run into seven figures a year.  

Early adopters of the programs were quick to protest the JAMA findings and criticism that the programs are too expensive. Since then, they've been gathering evidence to prove that such programs could, in fact, be an antidote for the high cost of providing care in ICUs and other healthcare settings.

Further, telemedicine advocates say, the programs can help alleviate the shortage of intensivists, improve access to care in remote or rural areas and across large systems with many hospitals, reduce mortality and length of stay, and even reduce ICU nurse turnover. 

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