810: Inter-Icu Transfers Reimagined: Comparing Telehealth and Traditional Transfer Evaluation Pathways

Introduction: Inter-ICU transfers to tertiary hospitals are critical in ensuring timely access to specialized care. Traditional transfer evaluations rely on phone-based discussions between referring and accepting teams. There is growing interest in leveraging telehealth to enhance these evaluations by incorporating real-time video assessments which may offer a nuanced understanding of patient status, contributing to more effective transfer decisions. The objective of our study was to compare the characteristics and outcomes of patients who underwent a pilot inter-ICU transfer telehealth evaluation (Tele) with those who received a traditional phone-based transfer evaluation (Trad). Methods: This was a retrospective observational study in a tertiary Medical ICU. ICU patients 18 years or older admitted to an outside hospital (OSH) with a request for transfer to our ICU between May 2024 to May 2025 were included. Evaluations were conducted either via Tele or Trad. Demographics and clinical outcomes were obtained by chart review. Transfer process metrics were extracted from a hospital dashboard. Descriptive statistics were performed to analyze results. Comparison between groups were performed using the Chi-square test or Fisher’s exact test. Results: We evaluated a total of 305 unique MICU transfer requests; 27 underwent Tele and 278 a Trad evaluation. 18.5% of patients in the Tele group and 23% in the Trad group were accepted for transfer. There were no significant differences between the two groups in age, gender, or acute illness severity scores. The Tele group had higher proportion of white (74.1% vs. 32.7%; p< 0.001), non-Hispanic (88.9% vs. 47.6%; p< 0.001) and Medicare patients (63% vs.35.6%; p=0.033). Notably, accepted patients in the Tele group had lower rate of death or hospice discharge disposition compared to the accepted patients in Trad group (40% vs 77.1%; p= 0.027). Conclusions: While mortality was lower among patients evaluated via Telehealth compared to Traditional evaluations, these results are based on unadjusted analyses and should be evaluated in larger cohorts with adequate sample size. Future work should also assess the value proposition of telehealth evaluations during transfer for patients, clinicians, and health systems in terms of outcomes, experience, and resource utilization.