• Jasleen Pannu, Devang Sanghavi, Todd Sheley, Darrell R Schroeder, Rahul Kashyap, Alberto Marquez, Craig E Daniels, Daniel R Brown, and Sean M Caples.
• 1Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.2Mayo Clinic Health System-Reporting and Analytics Team, LaCrosse, WI.3Division of Biostatistics, Mayo Clinic, Rochester, MN.4Division of Anesthesia and Critical Care Medicine, Mayo Clinic, Rochester, MN.
• Crit. Care Med. 2017 Aug 1; 45 (8): 134413511344-1351.

ObjectivesTo study the effects of tele-ICU monitoring on interhospital transfers from community-based ICUs to the quaternary care hospital at Mayo Clinic, Rochester, MN.DesignThis is a retrospective review of data on interhospital transfers comparing trends prior to tele-ICU implementation to those following implementation.SettingTele-ICU programs are increasingly utilized to fill resource gaps in caring for critically ill patients. How such programs impact population and bed management within a healthcare system are not known. Mayo Clinic serves as quaternary referral care center for hospitals in the region within the Mayo Clinic Health System. In August 2013, we implemented tele-ICU monitoring at six Mayo Clinic Health System hospital ICUs.SubjectsAll adult ICU admissions during the study period (preimplementation phase: January 1, 2012, to December 31, 2012; and postimplementation phase: January 1, 2014, to December 31, 2014) in any of the six specified community ICUs were included in the study.Measurements And Main ResultsInterhospital transfers significantly increased post institution of tele-ICU (p = 0.040) and was attributed primarily to transfer from less specialized ICUs (p = 0.037) as compared with more resource-intensive ICUs (p = 0.88). However, for such patient transfers, there were no significant differences before and after severity of illness scores, ICU mortality, or inhospital mortality.ConclusionIn a regional healthcare system, implementation of a tele-ICU program is associated with an increase in interhospital transfers from less resourced ICUs to the referral center, a trend that is not readily explained by increased severity of illness.

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