Background: The telemedicine intensive care unit (tele-ICU) enables remote monitoring and support for intensive care unit (ICU) patients, connecting onsite care teams with remote critical care specialists through audio–video links and electronic data. While it has been shown to improve outcomes and reduce costs in the U.S., evidence on tele-ICU in Japan is limited. The present study aimed to investigate the effectiveness and cost of the implementation of tele-ICU in Japanese hospitals. Methods: This retrospective cohort study used administrative data from two Japanese hospitals where tele-ICU was implemented in April 2018. All adult patients admitted to the ICUs from April 2014 to March 2022 were included. Interrupted time-series analysis was conducted to compare trends in in-hospital mortality, complications, and hospitalization costs before and after tele-ICU implementation, with adjustments for baseline characteristics. Results: A total of 26,684 patients were included. Of these, 10,981 (41%) and 15,703 (59%) were before and after tele-ICU implementation, respectively. After tele-ICU implementation, there were significant downward level changes for in-hospital mortality (−2.62%; 95% confidence intervals −4.08 to −1.16%) and hospitalization costs (−221 thousand yen per patient; −412 to −29.7). A significant downward slope change was observed for complications (−1.82% per year; −2.54 to −1.09%). Subgroup analysis revealed that the mortality reduction was observed mainly in medium-severity, nonsurgery, and general ICU patients. Conclusions: Tele-ICU implementation was associated with lower in-hospital mortality, fewer complications, and lower hospitalization costs, particularly among medium-severity and nonsurgical patients. Further multicenter prospective studies are warranted.
Kikuyama et al. (2026) studied this question.