Describing advanced practice provider roles within critical care teams with Tele-ICUs: Exemplars from seven US health systems

Optimizing the Potential for Telehealth in Cardiovascular Care (in the Era of COVID-19): Time Will Tell

“…37 Inpatient care may also benefit from implementing telemedicine. Cardiac care can adopt tele-intensive care unit team models, which use audiovisual communication to provide care to patients who are critically ill. 38 Advancements in cardiac monitoring devices are needed for the expansion of telehealth implementation. Increased use of devices for ambulatory monitoring such as patches, smartphones, wristwatches, vests, headbands, necklaces, and eyeglasses may have an impact on early detection of life-threatening conditions, reducing health care costs and unnecessary hospitalizations, and personalizing medicine.…”

Pilot of rapid implementation of the advanced practice provider in the workflow of an existing tele-critical care program

“…To our knowledge, this is the first report that describes the performance of the eAPP in teleCCM settings, utilizing ad hoc deployment and the hospital system demand-driven process. Prior reports assessed the eAPP for a large system with a pre-determined deployment [ 17 ]. However, such a model requires significant upfront expenditures and system investments that represent a barrier for incorporating an eAPP in patient care [ 16 , 21 , 26 ].…”

“…The healthcare field has strategically expanded the role of APPs into the critical care setting to meet the increasing demands for ICU provider resources across the United States [ 1 , 15 ]. Given the success of APPs at the bedside, it is interesting to find a relatively slow transition of APPs into a remote or teleCCM setting [ 9 , 17 ]. The COVID-19 pandemic provided impetus to incorporate APPs into the structure of telemedicine considering the physician shortage, the need to transfer patient care to a remote setting, the creation of non-ICU locations, and implement strategies to prevent long-term staff fatigue and shortages [ 3 , 16 , 18 ].…”

“…Although most APP work is in primary care, their expertise could be applied to the tele-Critical Care Medicine (teleCCM) system [ 18 – 21 ]. However, the relative paucity of data presenting integration of APP services into tele-ICU programs may be secondary to the insufficient record of publications as several programs that currently employ APPs in their teleCCM structure have failed to publish a peer-reviewed record of such an endeavor [ 17 ]. Incorporating APPs into teleCCM delivery could address several of the supply and demand problems associated with ICU providers, but data is lacking on potential workflows and outcomes, especially about the incorporation of their services in the existing model that would augment the teleCCM system [ 18 ].…”

Impact of Rurality on Melanoma Diagnosis in Utah

“…Telemedicine requires an upfront investment for a secure network, equipment and training of staff. Intermountain Healthcare currently has an infrastructure already developed for telemedicine [ 20 ] and has demonstrated decreased medical costs for telemedicine visits for low acuity urgent conditions [ 21 ], decreased neonatal intensive care unit (NICU) transfers from outlying community hospitals by utilizing physician-to-physician telemedicine consultations and increased utilization of advanced practice providers in intensive care units with telemedicine support [ 22 ]. Expansion of teledermatology in Utah, utilizing this pre-existing telemedicine network in urban and rural settings, could further promote the early diagnosis of melanoma.…”