A Retrospective Cohort Study to Assess the Impact of an Inpatient Infectious Disease Telemedicine Consultation Service on Hospital and Patient Outcomes.

BACKGROUND: Here we review our experience of providing inpatient Infectious Disease (ID) consultation using real-time interactive telemedicine assessment. We sought to obtain a baseline and trends regarding the use of telemedicine ID consults (teleID) as an adjunct to the standard of care through the time period when teleID consultations were begun. METHODS: Data were pulled via manual retrospective chart review of the electronic medical record (EMR). Primary outcomes included Length of Stay (LOS), antibiotic usage, and incidence of relapse. RESULTS: There were a total of 244 patients at one remote hospital site who were provided with ID consultation either in person or via teleID or both. Before availability of teleID (pre-teleID) there were 73 patients transferred and seen by ID, while 171 patients were seen via teleID when teleID became available. While all 73 patients in the pre-teleID group were transferred from the remote hospital to the hub hospital, only 14 (8.2%) of all remote hospital patients assessed by teleID were transferred. Patient LOS across both facilities decreased when patients were seen via teleID compared to pre-teleID (p=0.0001). The median number of days that patients received antibiotics decreased in the teleID group (median=15, IQR=9-25) compared to the pre-teleID group (median=19, IQR=11-28), but this decrease was not statistically significant (p=0.0770). There was no statistically significant difference in relapse rates, although data were lacking because of patients being lost to follow-up. CONCLUSIONS: ID telemedicine practice directed at inpatients appears to be a promising route of care