• Thomas E Robertson, Andrea R Levine, Avelino C Verceles, Jessica A Buchner, James H Lantry, Alfred Papali, Marc T Zubrow, L Nathalie Colas, Marc E Augustin, Michael T McCurdy, and Haiti Resource Limited Intensive Care (Haiti-RELIC) Study Group.
• Department of Medicine, University of Pittsburgh Medical Center, 200 N Lothrop St, Montefiore N715, Pittsburgh, PA 15213, United States.
• J Crit Care. 2017 Aug 1; 40: 145-148.

PurposeUltrasound (US) is a burgeoning diagnostic tool and is often the only available imaging modality in low- and middle-income countries (LMICs). However, bedside providers often lack training to acquire or interpret US images. We conducted a study to determine if a remote tele-intensivist could mentor geographically removed LMIC providers to obtain quality and clinically useful US images.Materials And MethodsNine Haitian non-physician health care workers received a 20-minute training on basic US techniques. A volunteer was connected to an intensivist located in the USA via FaceTime. The intensivist remotely instructed the non-physicians to ultrasound five anatomic sites. The tele-intensivist evaluated the image quality and clinical utility of performing tele-ultrasound in a LMIC.ResultsThe intensivist agreed (defined as "agree" or "strongly agree" on a five-point Likert scale) that 90% (57/63) of the FaceTime images were high quality. The intensivist felt comfortable making clinical decisions using FaceTime images 89% (56/63) of the time.ConclusionsNon-physicians can feasibly obtain high-quality and clinically relevant US images using video chat software in LMICs. Commercially available software can connect providers in institutions in LMICs to geographically removed intensivists at a relatively low cost and without the need for extensive training of local providers.Copyright © 2017 Elsevier Inc. All rights reserved.

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