TY - CHAP M1 - Book, Section TI - Telemedicine and Regionalization A1 - Kahn, Jeremy M. A2 - Hall, Jesse B. A2 - Schmidt, Gregory A. A2 - Kress, John P. PY - 2015 T2 - Principles of Critical Care, 4e AB - Intensive care unit practitioners increasingly will be required to develop, manage, and participate in regional systems of critical care.Regionalization and telemedicine are two strategies by which critical care can be coordinated across a region.Regionalization entails the systematic triage and transfer of high-risk critically ill patients to designated regional referral centers. Regionalization might improve outcomes by concentrating patients at high-quality centers of excellence and by increasing the efficiency of care.Important barriers to regionalization include the need for a strong central authority to regulate and manage the system and potential capacity strain at large-volume hospitals.Telemedicine entails the use of audio, visual, and electronic links to provide critical care across a distance. Telemedicine might improve outcomes by leveraging intensivist expertise across greater numbers of patients and facilitating local quality improvement, thereby improving access to high-quality critical care.Important barriers to telemedicine include the high cost of the infrastructure and operation, local resistance to organizational changes, and pragmatic barriers related to interoperability with existing clinical information systems.Both regionalization and telemedicine will play an important role in future critical care delivery. Critical care clinicians should be prepared to help shape these complementary approaches, as well as work to maintain patient centeredness in the face of a rapidly evolving critical care system. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1107712161 ER -