RT Book, Section A1 Barbash, Ian J. A1 Kahn, Jeremy M. A2 Schmidt, Gregory A. A2 Kress, John P. A2 Douglas, Ivor S. SR Print(0) ID 1201798653 T1 Telemedicine and Regionalization T2 Hall, Schmidt and Wood’s Principles of Critical Care, 5th Edition YR 2023 FD 2023 PB McGraw Hill PP New York, NY SN 9781264264353 LK accesssurgery.mhmedical.com/content.aspx?aid=1201798653 RD 2024/10/10 AB Intensive care unit practitioners will be increasingly called upon 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 central authority to regulate and manage the system and potential capacity strain at high-volume hospitals.Telemedicine entails the use of audio-visual technology to provide critical care across a distance. It 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 infrastructure and operation, local resistance or 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.