Operational model to increase intensive care unit telemedicine capacity rapidly during a pandemic: experience in India

Tele-ICU enabled management of an organ donor in an under-resourced setting

“…This tele-ICU model was refined during the COVID-19 pandemic and has since been adapted to efficiently treat patients requiring ICU level of care across a spectrum of complex conditions 14. In India, there is a disproportionately low number of ICU beds (2.3/100 000 population) with the disproportion most pronounced in rural regions 17.…”

“…This tele-ICU model offers a temporising solution to stabilise patients in order to maintain perfusion of vital organs while the logistics of transfer and organ procurement are organised. Tele-ICU models have been shown to be efficacious in a number of scenarios including resource-constrained settings 12 14 15 20 21. The immediate post-trauma stage, particularly in the context of brainstem death is extremely important in maintaining the viability of organs as well as providing resources and information to the family in helping them make decisions about organ donation 22.…”

“…Tele-ICU models facilitate skill transfer and capacity building through real-time remote consultation and support 20 27. One way that tele-ICU models facilitate skill transfer is through virtual training and best practice education 13 14. Tele-ICU models were instrumental in improving patient outcomes, reducing costs and addressing the shortage of critical care providers during the pandemic 14 20.…”

“…One way that tele-ICU models facilitate skill transfer is through virtual training and best practice education 13 14. Tele-ICU models were instrumental in improving patient outcomes, reducing costs and addressing the shortage of critical care providers during the pandemic 14 20. This can also help to improve the overall coordination and communication between remote and specialised healthcare providers, which can lead to better patient outcomes.…”

“…Tele-ICU uses high-end cameras, electronic medical records, mobile devices and secure video conferencing to connect patients in remote areas with critical care specialists. This platform provides real-time monitoring, notifications, secure communication and high-definition video feed, allowing patients in remote areas to receive critical care monitoring and access to specialist care, at a fraction of the cost needed to train and staff remote critical care facilities 14 15. By improving access to critical care services, tele-ICU may be able to play a crucial role in increasing the pool of potential organ donors.…”