RT Book, Section
A1 Kahn, Jeremy M.
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Kress, John P.
SR Print(0)
ID 1107712161
T1 Telemedicine and Regionalization
T2 Principles of Critical Care, 4e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071738811
LK accesssurgery.mhmedical.com/content.aspx?aid=1107712161
RD 2024/04/19
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.