PITTSBURGH (September 28, 2022) – A new study published in Open Forum Infectious Diseases suggests that Tele-Infectious Disease (ID) care can be an effective alternative to in-person ID care where in-person ID expertise is not available. This study is the first of its kind to compare inpatient outcomes between in-person ID versus Tele-ID at the same hospitals.
Conducted by UPMC, a leading academic medical center with an extended health system in Pennsylvania, New York, and Maryland, in partnership with Infectious Disease Connect, this 642-person, retrospective study demonstrated:
- A significantly greater volume of patients evaluated by Tele-ID – 391 consults for Tele-ID versus 251 in-person ID consults
- Slightly shorter average inpatient lengths of stay following an initial Tele ID consult for – Tele-ID cases – 3.9 days for Tele-ID compared to 4.1 days for in-person
- A decrease in readmissions following Tele-ID care; however, there were fewer patient transfers to tertiary centers following in-person ID care – 33 transfers compared to 40 transfers for Tele-ID patients
- 4.7% lower antimicrobial usage with Tele-ID care – 938 days of therapy per 1,000 patient-days (DOT/1000 PD) for Tele-ID care versus 984 DOT/1000 PD for in-person ID care
“The majority of counties in the United States still have no access to ID specialty care[i]. Despite the small sample size of this study, the study clearly suggests that hospitals can provide a comparable quality of care for ID patients through Tele-ID consultations,” said John W. Mellors, M.D., chief of the Infectious Diseases Division at UPMC. “As we continue to find innovative and effective tools to reduce social, economic and racial disparities in health care delivery, telemedicine can offer solutions for populations that are historically underserved by our current health care delivery system.”
Of note in this study, Tele-ID provided care for more medically complex patients with more diverse ID diagnoses than in-person care. The higher volume of patients evaluated by Tele-ID may have been related to the elimination of travel time required for in-person care.
“The research also suggests that Tele-ID can help improve utilization of local health care resources,” said lead author Nupur Gupta, D.O., MPH, clinical assistant professor in the Infectious Diseases Division at UPMC. “We also saw a trend suggesting that patients cared for via Tele-ID were more frequently discharged to their homes and experienced lower mortality rates within 30 days of their discharges.
In conducting this research, patient outcomes were evaluated for Tele-ID care and in-person ID care by examining patients’ medical records. The in-person group was seen between Jan. 1, 2018, and June 30, 2018. The Tele-ID group included patients seen between July 1, 2018, and Dec. 30, 2018. Data was extracted from electronic medical records for each population – including sex, race, age, body mass index, and Charlson Comorbidity Index scores which were captured and documented at the time of every in-person and Tele-ID consult.
The Tele-ID physician services provided in the study included live audio-video visits, electronic consults, and telephonic physician-to-physician consults. While not all patients required a live audio-video consult, when this type of care was warranted, the Tele-ID consults utilized a tele-presenter. Local registered nurses acted as tele-presenters and were trained on Health Insurance Portability and Accountability Act – compliant telecommunications equipment and performed comprehensive physical examinations using high-definition portable cameras and Bluetooth-enabled stethoscopes.
“Through ID Connect’s annual patient surveys, we regularly hear that patients and their caregivers are extremely satisfied with their Tele-ID experiences,” said Dave Zynn, former president and chief executive officer of ID Connect. “When patients have the full attention of a highly skilled ID specialist and the support of an in-person tele-presenter, the diagnostic and therapeutic approach is state-of-the art. Non-ID specialist physicians also value the ability to consult with ID experts and receive coaching for more common ID issues. High patient satisfaction scores for our Tele-ID services in combination with the data from this latest study, provide hospitals with the ability to improve the quality and reduce the costs of treating existing and emerging infectious diseases.”
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About Infectious Disease Connect
ID Connect is a world leader in telemedicine-enabled care of infectious diseases, antimicrobial stewardship, and infection control and prevention. Spun out of leading academic medical center UPMC, the company’s technology, precision medicine and data science are paired with world-class ID physicians to effectively manage infectious diseases across the U.S. At ID Connect, we strive to make people healthy, improve outcomes, and keep our communities free of infectious diseases. For more information, go to IDCtelemed.com
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A $24 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates more than 92,000 employees, 40 hospitals, 800 doctors’ offices and outpatient sites, and a more than 4-million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.5 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid more than $900 million in federal, state and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News consistently ranks UPMC Presbyterian Shadyside among the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com.
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[i] Walensky RP, McQuillen DP, Shahbazi S, Goodson JD. Where is the ID in COVID-19? Ann Intern Med 2020; 173:587–9.