TY  - CHAP
M1  - Book, Section
TI  - Chapter 8. Telemedicine
A1  - Breslow, Michael
A2  - Hall, Jesse B.
A2  - Schmidt, Gregory A.
A2  - Wood, Lawrence D.H.
PY  - 2005
T2  - Principles of Critical Care, 3e
AB  - Creating  a  centralized  ICU  care  system  provides  a  mechanism  for  implementing  24-hour  7-day  intensivist  oversight  of  critically  ill  patients  throughout  a  network  of  hospitals.A  major  goal  of  centralizing  ICU  care  is  to  spread  intensivist  care  over  larger  numbers  of  patients,  thereby  extending  both  the  number  of  patients  managed  by  an  intensivist  and  the  hours  of  intensivist  care.  Creating  a  multidisciplinary  remote  care  team  in  which  ICU  nurses  and  ancillary  personnel  work  in  support  of  the  remote  intensivist  is  central  to  maximizing  operating  efficiency.Available  data  suggest  that  implementing  a  remote  intensivist  management  program  that  supplements  on-site  physician  care  can  improve  clinical  outcomes  and  economic  performance.  We  speculate  that  dedicated  off-site  intensivists  improve  outcomes  by  closely  monitoring  patient  status  when  there  is  no  on-site  intensivist,  thereby  ensuring  that  care  plans  are  adhered  to  and  that  new  problems  are  detected  and  addressed  promptly.The  requisite  technology  includes  2-way  audio  and  high-resolution  video  links  to  each  patient  room,  a  robust  clinical  information  system  that  allows  off-site  physicians  to  access  patient  data,  technology  tools  for  performing  routine  care  tasks  (e.g.,  creating  notes  and  orders),  and  a  robust  and  secure  broadband  wide  area  network.Clear  definition  of  roles  and  responsibilities,  detailed  elucidation  of  operating  procedures,  including  how  the  remote  program  integrates  with  on-site  physician  activities,  and  ensuring  compliance  with  standard  inpatient  care  policies  (e.g.,  licensure,  credentialing,  quality  assurance,  and  the  Health  Insurance  Portability  and  Accountability  Act)  are  essential  for  a  smoothly  functioning  and  effective  program.Centralized  ICU  care  programs  as  part  of  a  system-wide  view  of  ICU  care  ensuring  consistent  24-hour  7-day  intensivist  oversight  and  the  use  of  an  information  technology  backbone,  create  unique  opportunities  to  standardize  care  practices,  enhance  operating  effectiveness,  and  improve  outcomes.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2023/05/30
UR  - accesssurgery.mhmedical.com/content.aspx?aid=2295849
ER  -