Bedside Critical Care Staff Use of Intensive Care Unit Telemedicine: Comparisons by Intensive Care Unit Complexity

Abstract

ICU telemedicine needs to develop an agreed upon typology for documenting ICU telemedicine utilization and incorporate these measures into models of its effect on clinical outcomes.

Telemedicine Coverage of Intensive Care Units: A Narrative Review

“…The authors reported no difference in severity-adjusted mortality or LOS post-intervention. However, they did report decreased mortality for the most severely-ill patients after ICU telemedicine implementation, which is consistent with findings from several other studies (41,53,55,56). In another study conducted within the Veterans Affairs Healthcare System using a methodologically rigorous design across seven hospitals with matched controls, authors did not find an association of ICU telemedicine with patient outcomes, but noted that their study cohort had an extremely low ICU mortality rate of 2.9%, making it difficult to detect a statistically significant reduction in mortality (54).…”

“…These positive findings were reinforced by a large study in a single academic center published in 2011 (16). Notably, in this study, remote (49,53). The authors reported no difference in severity-adjusted mortality or LOS post-intervention.…”

“…By identifying individual domains associated with improved outcomes post-ICU telemedicine implementation, authors offered plausible mechanisms for the potential effectiveness of this intervention(29). Finally, a recent large national study evaluating the effectiveness of ICU telemedicine programs with concurrent controls showed a small relative mortality reduction with wide variation in ICU telemedicine effect across adopting hospitals, although this study used an administrative database that lacked detailed clinical risk adjustment(52).However, multiple other observational studies with similar limitations did not find any association of ICU telemedicine with improved patient outcomes(42,53,54). Specifically, one study in multiple ICUs across a large US healthcare system evaluated the association of ICU telemedicine with patient outcomes.…”

Telehealth for people with spinal cord injury: a narrative review

“…Moreover, insurance carriers are realizing the benefits of telehealth and it is being frequently reimbursed. Telemedicine is also being used more and more for emergency care and crisis management [7]. The lack of qualified providers, the high costs and burden of transportation for persons with SCI and their frequent common acute health problems, such as urinary tract infections, pressure sores and respiratory concerns, make teleSCI an ideal way to provide care.…”

“…Telemedicine was used as early as in the 1930s for telephone consultations for passengers on the Queen Mary [3]. Recently, the use of telemedicine has expanded rapidly with services available directly to patient for common concerns, such as upper respiratory and urinary tract infections [4] and through consultation from healthcare facilities for issues such as diabetic retinopathy [5], acute stroke [6] and intensive care unit patient management [7].…”