ArticleTelemedicine reports
How Does Tele-ID Inpatient Care Compare to In-Person Care? Results from a Tertiary Academic Medical Center.
Article in Telemedicine reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Remote telemedicine ID consults (Tele-ID) are effective for community hospital inpatients. Tele-ID is not used at academic medical centers (AMCs) as onsite ID physicians are often available. During the COVID-19 pandemic, intra-hospital Tele-ID was implemented to conserve PPE and reduce SARS-CoV-2 exposure. In this study, we compared outcomes of Tele-ID to in-person ID. Methods: A longitudinal, matched, case-control study was conducted at three Pittsburgh tertiary AMCs. Cases were evaluated via Tele-ID (video, e-consults, and telephonic consults) between 3/1/20 and 5/31/20. In-person consults between 3/1/19 and 11/30/19 were matched by demographics, transplant status, comorbidity indices, and ID-specific diagnoses. Both groups were evaluated by general ID (GID) or transplant ID (TID) physicians. Patients with COVID-19 were excluded. Outcomes included in-hospital, and 30-day mortality, 30-day readmission, intensive care unit (ICU) admission, and ICU length of stay (LOS). Results: Among the Tele-ID group, 125 inpatients were evaluated by GID and 81 by TID. The majority were Caucasian, male, and non-ICU. A broad range of ID diagnoses were made, most commonly bacteremia and pneumonia. Average hospital LOS post-ID consult was 6.26 days (GID) and 6.5 days (TID). For ICU patients, average LOS was 12 days (GID) and 7.6 days (TID). There were 5 (4%) and 3 (3.7%) in-hospital deaths, and 3 (2.4%) and 5 (6.2%) deaths at 30 days for GID and TID, respectively. 173 cases were matched to 966 controls by ID diagnosis. Rates of 30-day readmission, ICU admission, in-hospital and 30-day mortality were similar between groups. ICU LOS was shorter in the Tele-ID group (70 vs. 386 h; Conclusions: During the pandemic, intra-hospital Tele-ID was an effective alternative to in-person ID consults at large AMCs, with shorter ICU LOS and similar 30-day readmission, ICU admission, in-hospital and 30-day mortality, and suggests that Tele-ID can be used at AMCs safely and effectively in non-pandemic settings.
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