The 2019 novel coronavirus (COVID-19) pandemic has forced many hospital systems to incorporate telehealth to deliver routine outpatient care as well as intensive care unit (ICU) services without the risk of exposure to the virus. However, a 2018 survey by the American Hospital Association found that only about half of hospitals in the United States have pre-existing telemedicine systems, according to a study in Annals of Internal Medicine.
“Given that COVID-19 requires reorganization of healthcare delivery, a large proportion of hospitals will need to develop infrastructure for both tele-office visits and tele-ICU,” reported the investigators. This “will likely require rapid investment in developing the infrastructure needed to deliver patient care remotely and share limited health care resources across hospitals in light of the COVID-19 pandemic.”
Researchers analyzed data from the survey to evaluate the proportion of hospitals that reported availability of telehealth consultation and office visits (virtual care and outpatient visits) and tele-ICU; virtual staffing of ICU patients by remote critical care specialists). A total of 4400 hospitals responded to the 2018 survey and supplemental information was obtained for 311 additional hospitals from a 2017 survey. The assessment of tele-ICU was available for 2816 hospitals with at least 1 ICU bed.
Of the 4711 hospitals, 2243 (47.6%) reported offering telehealth-based consultation and office visit services; these hospitals tended to be large, private, not-for-profit, teaching hospitals. Of the hospitals with ICUs, 756 (26.8%) reported tele-ICU capabilities. These hospitals tended to be private, not-for-profit hospitals vs those without telehealth ICUs.
Large regional variation was found among hospitals that offered telehealth consultation and office visit services across the United States; 25 states or territories reported these services in less than half of hospitals. Hospitals with ICU beds that were equipped with tele-ICU services also reported regional variation, from no tele-ICU hospitals in Puerto Rico compared with 4 out of 5 hospitals in Wisconsin.
Jain S, Khera R, Lin Z, Ross JS, Krumholz HM. Availability of telemedicine services across hospitals in the United States in 2018: a cross-sectional study [published online April 30, 2020]. Ann Intern Med. doi: 10.7326/M20-1201