A Survey of Tele-Critical Care State and Needs in 2019 and 2020 Conducted among the Members of the Society of Critical Care Medicine

Abstract

The study’s objective was to assess facilitators and barriers of Tele-Critical Care (TCC) perceived by SCCM members. By utilizing a survey distributed to SCCM members, a cross-sectional study was developed to analyze survey results from December 2019 and July 2020. SCCM members responded to the survey (n = 15,502) with a 1.9% response rate for the first distribution and a 2.54% response rate for the second survey (n = 9985). Participants (n = 286 and n = 254) were almost equally distributed between non-users, providers, users, and potential users of TCC services. The care delivery models for TCC were similar across most participants. Some consumers of TCC services preferred algorithmic coverage and scheduled rounds, while reactive and on-demand models were less utilized. The surveys revealed that outcome-driven measures were the principal form of TCC performance evaluation. A 1:100 (provider: patients) ratio was reported to be optimal. Factors related to costs, perceived lack of need for services, and workflow challenges were described by those who terminated TCC services. Barriers to implementation revolved around lack of reimbursement and adequate training. Interpersonal communication was identified as an essential TCC provider skill. The second survey introduced after the onset pandemic demonstrated more frequent use of advanced practice providers and focus on performance measures. Priorities for effective TCC deployment include communication, knowledge, optimal operationalization, and outcomes measurement at the organizational level. The potential effect of COVID-19 during the early stages of the pandemic on survey responses was limited and focused on the need to demonstrate TCC value.

Elucidation of the needs for telecritical care services in Japan: a qualitative study

“…This result is consistent with that of previous studies reporting high levels of staff acceptance of telecritical care 7 8. However, to achieve further acceptance from all frontline medical staff, it is crucial that individuals providing teleconsultation have good communication skills and a system that guarantees and trains frontline medical staff about the technology before implementation 27…”

“…7 8 However, to achieve further acceptance from all frontline medical staff, it is crucial that individuals providing teleconsultation have good communication skills and a system that guarantees and trains frontline medical staff about the technology before implementation. 27 The most common advice was related to treatment, and the content ranged from general advice to advice on medication and electrolyte correction methods, which require detailed adjustments. Furthermore, there was only one question about treatment 'techniques', probably because teleconsultations were conducted by video or telephone call, making it difficult for onsite physicians to immediately perform the procedures with which they have no experience, despite receiving instructions.…”