Telemedicine/Virtual ICU: Where Are We and Where Are We Going?
Chiedozie Udeh, Belinda Udeh, Nadeem Rahman, Christina Canfield, Jack Campbell, J Steven Hata, Chiedozie Udeh, Belinda Udeh, Nadeem Rahman, Christina Canfield, Jack Campbell, J Steven Hata
Abstract
Intensive care unit telemedicine (tele-ICU) is technology enabled care delivered from off-site locations that was developed to address the increasing complexity of patients and insufficient supply of intensivists. Although tele-ICU deployment is increasing, it continues to cover only a small proportion of ICU patients. This is primarily due to expense, with first-year costs exceeding $50,000 per bed. Meta-analyses of outcomes indicate survival benefits and quality improvements, albeit with significant heterogeneity. Depending on the context, a wide range of estimated incremental cost-effectiveness ratios reflects variable effects on cost and outcomes, such as mortality or length of stay. Tele-ICUs may fit within a hybrid model of care to complement high-intensity ICU staff coverage. However, more research is required to foster consensus and determine best practices. This review summarizes data on tele-ICU structure, operations, outcomes, and costs. Evidence was extracted from meta-analyses, with secondary data from Cleveland Clinic's tele-ICU experience.
Keywords: ICU; cost-effectiveness; critical care; intensive care unit; outcomes; telemedicine.
Conflict of interest statement
Conflict of Interest Disclosure: The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.
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Source: PubMed