Tele-ICU: Experience To Date

Abstract

Tele-intensive care unit (ICU) is a care provided to critically ill patients by off-site clinicians using audio, video, and electronic links to leverage technical, informational, and clinical resources. Providing care includes the ability to detect patient's instability or laboratory abnormalities in real-time, collect additional clinical information from or about the patient, order diagnostic testing, make diagnoses, implement treatment, render other forms of intensive care such as managing life-support devices, and communicate with patients and bedside providers. This review summarizes how tele-ICU services are delivered, the alternative approaches that have been used, and summarizes published reports of its effects on patient-focused outcomes. Tele-ICU is thought to have great promise to support critically ill adults.

International health IT benchmarking: learning from cross-country comparisons

“…For example, telehealth can provide access to advanced services that would not otherwise be available in rural and remote areas. 10,11 The effective use of electronic records can also facilitate transparency, clinical research, effective public health planning, and the evaluation of health care interventions and their quality at the practice level. At the same time, risks can be introduced if health ICT is not implemented and used appropriately.…”

Benchmarking health IT among OECD countries: better data for better policy

“…For example, advancements in telecommunications have led to the emergence of tele-ICUs in which specialists can remotely monitor and direct care for the sickest patients who might otherwise lack access to such advanced care. 9 Governments have recognized the large-scale changes that are made possible by health ICTs and in response they are developing approaches to leverage these technologies to pursue a range of health system reforms, such as primary care renewal and pay for performance. The first step towards realizing the array of potential benefits from health ICTs is for governments to develop an e-health strategy.…”

A New View: Tele–Intensive Care Unit Competencies

“…Patients' data are available and transferred via high-speed, protected connections to and from multiple ICUs, and a state-of-the art audio/video system allows real-time visual assessment of the patient and direct collaboration with the bedside team. 11,12 The tele-ICU staff uses continuous monitoring and virtual rounding (a thorough review of patient-specific data including vital signs, laboratory andradiology results, physicians' notes, flow sheet data, and a possible camera assessment) to identify actual or potential problems with patients and intervenes to prevent a crisis for a patient. Today, more than 1 million critically ill patients have been cared for by using tele-ICU systems.…”

“…There is discussion in the literature of an unusually strong team bond between the tele-intensivist and the tele-ICU nurse. 11,12,[29][30][31] However, despite the strong team bond, works full time in tele-ICU), shared staff (nurse works in both tele-ICU and local ICU), or mixed (combination of both models). 11,30 Although survey results favor a mixed model, respondents' comments indicate that models shift depending on the applicants available and the growth of the program.…”

“…The success of the tele-ICU in achieving its goal of improved outcomes for patients relies on the ability to provide care in an ICU/tele-ICU collaborative environment. [9][10][11][12][29][30][31][32] Without a high high-risk/lowvolume clinical issues and equipment, (2) mandatory continuing education credits in clinical topics, and (3) attendance at a hospital skills laboratory.…”