1738: From Pandemic Response to Clinical Excellence: Tele-Icu Model Improves Outcomes for Sicker Patients

Introduction: The COVID-19 pandemic led to a massive expansion of critical care capacity in India. A new challenge emerged as the acute crisis subsided: how to sustain and effectively utilize this expanded infrastructure beyond the pandemic. This AI augmented tele-ICU model offers a promising solution for a broad spectrum of non-COVID critical care needs, thereby driving long-term improvements in care delivery, enhancing access for underserved populations, and improving patient outcomes. Methods: This retrospective cohort analysis examined ICU admissions from June 2020 to September 2024 in a network of tele-ICU-supported hospitals in India. Data were collected on daily admission volumes, primary ICD-10 diagnoses and demographics. Outcomes measured and tracked included compliance with Hand hygiene, Deep Vein thrombosis (DVT) prevention bundle and CLABSI prevention bundles. Mortality for patients on pressors and those invasively ventillated, and ventilator-free days (VFD). Regression models were used to quantify trends over time, with a focus on non-COVID admissions and trends in APACHE II scores. Results: Analysis of 52 months of data across 217 healthcare units revealed a significant shift in ICU utilization. Non-COVID-19 admissions showed a highly significant upward trend, increasing by an average of 55 admissions per month (β=55.17,p< 0.001). Statistically significant monthly increases were found for sepsis, acute coronary syndromes, and various neonatal conditions (all p< 0.001). Despite an increasing severity of illness (average APACHE II score increased by 0.09 points per month, β=0.094,p< 0.001), the tele-ICU model was associated with improved clinical and QI outcomes.There was a 22.57% net reduction in hospital mortality among pressor patients and a 27.75% mortality reduction in invasively ventillated patients. VFD also significantly increased by 0.088 days per month (p< 0.001). Conclusions: The implementation of a technology-augmented tele-ICU model provided an effective strategy for repurposing critical care infrastructure originally established for the COVID-19 pandemic. The sustained improvements in clinical metrics, including mortality and VFD, highlight the value of tele-ICU models as a sustainable solution for enhancing high-quality critical care services in resource-constrained settings.