The Connected Intensive Care Unit Patient: Exploratory Analyses and Cohort Discovery From a Critical Care Telemedicine Database.

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BACKGROUND Many intensive care units ICUs utilize telemedicine in response to an expanding critical care patient population off hours coverage and intensivist shortages particularly in rural facilities Advances in digital health technologies among other reasons have led to the integration of active well networked critical care telemedicine tele ICU systems across the United States which in turn provide the ability to generate large scale remote monitoring data from critically ill patients OBJECTIVE The objective of this study was to explore opportunities and challenges of utilizing multisite multimodal data acquired through critical care telemedicine Using a publicly available tele ICU or electronic ICU eICU database we illustrated the quality and potential uses of remote monitoring data including cohort discovery for secondary research METHODS Exploratory analyses were performed on the eICU Collaborative Research Database that includes deidentified clinical data collected from adult patients admitted to ICUs between 2014 and 2015 Patient and ICU characteristics top admission diagnoses and predictions from clinical scoring systems were extracted and analyzed Additionally a case study on respiratory failure patients was conducted to demonstrate research prospects using tele ICU data RESULTS The eICU database spans more than 200 hospitals and over 139 000 ICU patients across the United States with wide ranging clinical data and diagnoses Although mixed medical surgical ICU was the most common critical care setting patients with cardiovascular conditions accounted for more than 20 of ICU stays and those with neurological or respiratory illness accounted for nearly 15 of ICU unit stays The case study on respiratory failure patients showed that cohort discovery using the eICU database can be highly specific albeit potentially limiting in terms of data provenance and sparsity for certain types of clinical questions CONCLUSIONS Large scale remote monitoring data sources such as the eICU database have a strong potential to advance the role of critical care telemedicine by serving as a testbed for secondary research as well as for developing and testing tools including predictive and prescriptive analytical solutions and decision support systems The resulting tools will also inform coordination of care for critically ill patients intensivist coverage and the overall process of critical care telemedicine
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