Remote monitoring of intensive care just as good but no better

The controversy of the subject is illustrated by the spin delivered in these two stories:

• Use of telemedicine for ICU patients not linked with improvement in survival.
• No added risk associated with ICU patients monitored remotely.

Why the big difference? The authors of the first story see telemedicine as expensive and find the shortage of intensive care physicians dangerous. The authors of the second story see telemedicine as falling in price and thus focus on costs.

The study was done by medical directors at the Texas ICUs where the study took place.

What this really means is that productivity among "intensivists," as doctors specializing in intensive care are known, is now free to rise. Telemedicine technology lets each doctor treat more patients simultaneously, with little added risk.

In addition to improving productivity, the study also means that intensive care could be delivered in more locations, even where no intensivist is present. This means less travel for patients needing care.

Studies will now need to be done measuring just how many patients each intensivist can monitor, using technology, before the risk of death rises. Measures also need to be taken on how risks and costs measure up depending on the skills and training of others on the team, like nurses.

The result over time is going to be lower-cost intensive care, but as with all such promises the improvements must come in gradually.