Study shows life-saving potential of sustained tele-critical care for veterans in the ICU

When a veteran is admitted to the ICU, every minute matters. Enter tele-critical care, which adds a virtual safety net to the bedside team, including experienced critical care physicians and nurses who monitor patients remotely, 24/7, using real-time data from bedside monitors, ventilators, labs, electronic medical records and other equipment. Through multiple interfaces, TCC enables management of multiple patients by a team of tele-intensivists, aiding in early detection and intervention. This model doesn’t replace bedside care; it reinforces it with continuous oversight, rapid consultation, and support for standardized best practices across facilities.

While TCC is generally known to be associated with improved critical care outcomes [1], a recent study published in Critical Care Medicine looked deeper into how the duration of TCC implementation affected clinical outcomes in U.S. Department of Veterans Affairs (VA) hospitals as measured by ICU deaths (mortality), length of stay (LOS) and the use of mechanical ventilation.

A large VA analysis found that the longer tele-critical care is in place, the more veterans may benefit. Across 35 VA hospitals and more than 190,000 ICU stays from 2012 to 2019, hospitals with several years of sustained tele-critical care saw fewer deaths than expected for how sick patients were, with the impact on mortality rates becoming most pronounced after about five years of continuous use. ICU stays also became shorter relative to patient severity, with a clear signal emerging after four to five years. Overall, researchers concluded that extended tele-critical care implementation improved ICU mortality rates and reduces ICU length of stays. Additionally, use of invasive mechanical ventilation trended downward across the program overall, though that specific trend was not directly tied to the duration of tele-critical care at a given site.

Time may play a key factor in a measurable tele-critical care impact because, according to the study authors, “adopting and spreading new technologies in healthcare can be challenging…it can take a long time for new technology to be implemented into clinical practice.” While adoption may be gradual, as bedside and remote teams build trust, align workflows, and reinforce evidence-based protocols, the “virtual safety net” may become more tightly integrated into daily practice.

For veterans and their families, the impact of tele-critical care is meaningful. Continuous expert oversight means a second set of trained eyes can help catch early warning signs and support faster, coordinated action—day or night. Standardized approaches help deliver the same high-quality care whether a veteran is in a large medical center or a smaller facility, including rural sites. And because benefits build with sustained use, mature tele-critical care programs are positioned to translate experience into better care and shorter ICU stays over time.

It’s important to note that this was a retrospective analysis showing associations, not proof of causation. VA hospitals and veteran populations are unique, and VA hospital ICUs can vary in size, staffing, program types and clinical practices, which limits generalizability to other systems and may have introduced confounding factors. Outcomes were evaluated relative to expected benchmarks based on patient severity, and those predictive models were not trained on VA-specific data. Even so, the consistency of the signal over time provides compelling real-world evidence from a large, nationwide program. Further research is needed to explore the mechanisms behind the demonstrated improvements and factors influencing the successful adoption of tele-critical care in healthcare settings.

The analysis covered 193,367 ICU stays across 35 VA hospitals from 2012–2019 within the VA National TeleCritical Care Program, supported by a Philips tele-critical care platform. The research was published in Critical Care Medicine (2025).