Telemedicine in Pediatric Intensive Care Units: Perspectives From a Brazilian Experience

Vanessa Cristina Jacovas, Maria Eulália Vinadé Chagas, Hilda Maria Rodrigues Moleda Constant, Suelen Stihl Alves, João Ronaldo Mafalda Krauzer, Luciano Remião Guerra, Aristóteles de Almeida Pires, Luciane Gomes da Cunha, Maria Cristina Cotta Matte, Taís de Campos Moreira, Felipe Cezar Cabral, Vanessa Cristina Jacovas, Maria Eulália Vinadé Chagas, Hilda Maria Rodrigues Moleda Constant, Suelen Stihl Alves, João Ronaldo Mafalda Krauzer, Luciano Remião Guerra, Aristóteles de Almeida Pires, Luciane Gomes da Cunha, Maria Cristina Cotta Matte, Taís de Campos Moreira, Felipe Cezar Cabral

Abstract

Purpose of review: To present the implementation of a telemedicine project (TeleICU) in pediatric intensive care units (ICU) throughout different Brazilian regions.

Recent findings: Although telemedicine in pediatric ICUs has shown evidence of benefit in numerous studies with potential to 18 mitigate existing disparities, in Brazil, its use is still under development. Brazil has several opportunities for implementing this resource since, according to the National Registry of Healthcare 20 Establishments (NRHE), there is a discrepancy in the density of pediatric intensive care physicians per patient and the availability 21 of pediatric ICU beds per number of inhabitants.

Summary: Health technologies are being widely used to fill gaps in the healthcare system. Telemedicine has been an important tool to meet demands in intensive care units, especially the demand for specialized assistance. TeleICU is a Brazilian model of telemedicine that performs multidisciplinary telerounds in remote pediatric ICUs and develops continuing education activities for the healthcare teams. The project aims to systematize and to qualify care, as well as to reduce risks for patients admitted to pediatric ICUs engaged in the project. Preliminary results have demonstrated a positive impact regarding this approach, providing medical care to 6640 inpatients-day in two Brazilian pediatric ICUs, for 616 patients during 946 daily telerounds.

Supplementary information: The online version contains supplementary material available at 10.1007/s40124-021-00242-z.

Keywords: Pediatric intensive care unit; Pediatrics and critical care; Telemedicine.

Conflict of interest statement

Conflict of InterestThe authors declare no competing interests.

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.

Figures

Fig. 1
Fig. 1
A Graphic representation of the density of pediatric physicians in Brazil (number of pediatric physicians/total population times 10,000; B Graphic representation of the density of pediatric ICU beds in Brazil (number of available beds/total population times 100,000) according to federative unit (source: adapted from the National Registry of Healthcare Establishments)
Fig. 2
Fig. 2
Items assessed in each domain considered in the project’s implementation visits. Red cells represent a negative score (the worse the assessment, the greater the weight). Green cells represent a positive score (the better the assessment, the better the scores). Blue cells represent negative scores towards the extreme evaluations (very good and inadequate) and positive scores in regular evaluations
Fig. 3
Fig. 3
A Photo of the telemedicine station located in the command center (Hospital Moinhos de Vento, Porto Alegre, RS) and B telemedicine station and the intensive care pediatric physicians. The remote center is equipped with a telemedicine cart (C), which is located by the team by the bedside in order to allow patients’ assessments (D)

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