American journal of medical quality : the official journal of the American College of Medical Quality
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Intensive care unit telemedicine involves nurses and physicians located at a remote command center providing care to patients in multiple, scattered intensive care units via computer and telecommunication technology. The command center is equipped with a workstation that has multiple monitors displaying real-time patient vital signs, a complete electronic medical record, a clinical decision support tool, a high-resolution radiographic image viewer, and teleconferencing for every patient and intensive care unit room. ⋯ This article reviews the technology's background, status, significance, clinical literature, financial effect, implementation issues, and future developments. Recommendations from a University HealthSystem Consortium task force are also presented.
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Whether prior use of Veterans Affairs services is a marker for increased mortality was evaluated by using Medicare data for men aged 67 years and older admitted for acute myocardial infarction, chronic heart failure, chronic obstructive pulmonary disease, pneumonia, or stroke during 1996 to 2002. Patients using Veterans Affairs services during the 2 years preceding hospital admission were identified using Veterans Affairs encounter data, and 30-day mortality was compared in patients who did and did not use Veterans Affairs services, adjusting for patient risk factors. ⋯ Results using propensity-matched samples were similar. The use of Veterans Affairs services is not a strong marker of unmeasured severity among patients in private sector hospitals.