Intensive Care Unit Telemedicine, An Issue of Critical Care Clinics, Volume 35-3

This issue of Critical Care Clinics, edited by Dr. Kianoush Kashani in collaboration with Consulting Editor Dr. John Kellum, is focused on Intensive Care Unit Telemedicine. Topics in this issue include: ICU telemedicine program administration: from start to full implementation; ICU telemedicine multidisciplinary care teams; ICU telemedicine technology; Impact of ICU telemedicine on outcomes; Quality assurance of ICU telemedicine; ICU telemedicine cost-effectiveness and financial analyses; ICU telemedicine care models; ICU telemedicine in the era of big data, artificial intelligence, and computer clinical decision support systems; ICU Telemedicine: Innovations and Limitations; ICU telemedicine: provider-patient satisfaction; and ICU telemedicine services beyond medical management: Tele-pharmacy, tele-procedure, tele-dialysis, tele-stroke: evidence, benefits, risks, and legal ramifications.

 Table of contents:

·  Important Administrative Aspects of Critical Care Telemedicine Programs

·  Key points

·  Introduction

·  Discussion

·  Summary

·  TeleICU Interdisciplinary Care Teams

·  Key points

·  Introduction

·  The essential TeleICU team structure

·  TeleICU team members

·  Getting teams to work together: the Synergy Model

·  Communication is key

·  Varying intensive care unit environments

·  Potential team extensions

·  One or multiple hub sites?

·  Additional uses of the TeleICU team/technology

·  Summary

·  Tele-ICU Technologies

·  Key points

·  Introduction

·  History and evolving technology of telemedicine in the intensive care unit

·  Tele-ICU technology

·  Hardware and software specifications

·  Regulations and cybersecurity

·  Health information technology standards and interoperability

·  Vendors and Tele-ICU technologies

·  Technology is important, but it is not everything

·  Impact of Intensive Care Unit Telemedicine on Outcomes

·  Key points

·  Meta-analysis

·  Process of care outcomes

·  Association of intensive care unit and intensive care unit telemedicine integration with results

·  Hospital impacts

·  Patients and providers

·  Final thoughts

·  Quality Improvement and Telemedicine Intensive Care Unit: A Perfect Match

·  Key points

·  Introduction

·  Medical errors in the intensive care unit and increasing safety in tele-intensive care using quality improvement tools

·  Quality improvement methodology examples: plan–do–study–act cycles, define–measure–analyze–improve–control, and lean

·  Tele-intensive care and its role in enhancing intensive care unit quality of care

·  Continuous quality improvement by tele-intensive care

·  Leveraging current and future knowledge to enhance intensive care unit metrics by tele-intensive care

·  Resource use and project prioritization

·  Diffusion of best practices across all intensive care units

·  Impact of quality improvement by tele-intensive care on interhospital transfers

·  Continuous quality improvement use in tele-intensive care

·  Handoff communication

·  Summary

·  Evolution of the Intensive Care Unit Telemedicine Value Proposition

·  Key points

·  Early warning systems

·  Intensive care unit telemedicine patient monitoring systems

·  Automated acuity and transfer readiness

·  Communication for team harmony and patient safety

·  Intensive care unit telemedicine sign-in and -out procedures enhance situational awareness

·  Delivering medical management and documentation services: more than advice

·  Pathways for escalation

·  Workforce leveraging

·  Incremental staffing resources for nascent physiologic instability

·  Teamwork for continuous management

·  An interprofessional approach to logistical support

·  Decreased time to rescue

·  Logistical support to increased access to care

·  Financial performance: a matter of perspective

·  Summary

·  Intensive Care Unit Telemedicine Care Models

·  Key points

·  Introduction

·  Basic principles

·  Intensity of the care models

·  Quality improvement

·  Intensive care unit telemedicine as a model for medical education

·  Summary

·  Intensive Care Unit Telemedicine in the Era of Big Data, Artificial Intelligence, and Computer Clinical Decision Support Systems

·  Key points

·  Introduction

·  History

·  State of clinical decision support systems in the telemedicine intensive care unit

·  Future telemedicine intensive care unit applications of machine learning

·  Telemedicine intensive care unit clinical decision support system considerations

·  Summary

·  Intensive Care Unit Telemedicine: Innovations and Limitations

·  Key points

·  Introduction

·  Recent innovations in intensive care unit telemedicine

·  Opportunities for intensive care unit telemedicine innovation

·  Limitations

·  Summary

·  Satisfaction in Intensive Care Unit Telemedicine Programs

·  Key points

·  Introduction

·  Tools for evaluating patient and provider satisfaction in an intensive care unit telemedicine program

·  Factors that affect satisfaction

·  Standards for measuring satisfaction in an intensive care unit telemedicine program

·  Summary

·  Appendix

1. Teamwork Climate Scale and Safety Climate Scale items

·  Expansion of Telemedicine Services: Telepharmacy, Telestroke, Teledialysis, Tele–Emergency Medicine

·  Key points

·  Introduction

·  Telepharmacy

·  Telestroke

·  Teledialysis

·  Tele–emergency medicine

·  Other telehealth services