Background:The rapid response team (RRT) concept was developed to improve care for decompensating patients outside of the intensive care unit (ICU) setting. The tele-ICU service (eICU®) at Health First Hospitals (Brevard County, FL) has provided tele–critical care support for patients outside the ICU using a mobile platform (the eMobile platform) since 2012. In this study we sought to evaluate the ability of eMobile to support care administered by RRTs.Materials and Methods:A retrospective review evaluating mobile cart activations for RRT calls was performed. Data on mobile cart deployments were recorded over a 33-month period from January 2012 through September 2014.Results:Five hundred eighty mobile cart activations for critical care support were initiated by RRTs, and 577 were completed (>99%). For recorded gender, 223 patients (47%) were male, and 248 (53%) patients were female. Mean recorded age was 70 ± 16 years (median, 72 years). The most common patient conditions were respiratory distress (n = 190, 33%), altered mental status (n = 137, 24%) and hypotension (n = 59, 10%). The most common interventions were medication orders (n = 231, 40%) and laboratory studies (n = 92, 29%). For 566 eMobile calls with documented dispositions, 189 patients (33%) were managed without ICU upgrade. No adverse patient outcomes were recorded involving eMobile. Compared with the RRT program in 2009, the last year before testing of eMobile began (2010–2011), addition of tele–critical care support for calendar years 2012 and 2013 increased projected cost avoidance from unnecessary ICU transfers by a mean of 66% above the 2009 baseline. For Fiscal Year 2014, a projected cost avoidance analysis for unnecessary ICU transfers including costs of information technology (IT) support demonstrated a return on investment up to $1.66 for every $1 invested in IT support.Conclusions:Mobile critical care coupled with RRT is clinically effective and can generate meaningful cost avoidance.
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