Critical care clinics
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Critical care clinics · Jul 2019
ReviewIntensive Care Unit Telemedicine in the Era of Big Data, Artificial Intelligence, and Computer Clinical Decision Support Systems.
This article examines the history of the telemedicine intensive care unit (tele-ICU), the current state of clinical decision support systems (CDSS) in the tele-ICU, applications of machine learning (ML) algorithms to critical care, and opportunities to integrate ML with tele-ICU CDSS. The enormous quantities of data generated by tele-ICU systems is a major driver in the development of the large, comprehensive, heterogeneous, and granular data sets necessary to develop generalizable ML CDSS algorithms, and deidentification of these data sets expands opportunities for ML CDSS research.
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Critical care clinics · Jul 2019
ReviewIntensive Care Unit Telemedicine: Innovations and Limitations.
Intensive care unit (ICU) telemedicine is an established entity that has the ability to not only improve the effectiveness, efficiency, and safety of critical care, but to also serve as a tool to combat staffing shortages and resource-limited environments. Several areas for future innovation exist within the field, including the use of advanced practice providers, robust inclusion in medical education, and concurrent application of advanced machine learning. The globalization of critical care services will also likely be predominantly delivered by ICU telemedicine. Limitations faced by the field include technical issues, financial concerns, and organizational elements.
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Critical care clinics · Jul 2019
ReviewQuality Improvement and Telemedicine Intensive Care Unit: A Perfect Match.
The health care delivery system is complex. New technologies offer new treatment options. The process of quality improvement includes system re-engineering. ⋯ Its core characteristic is the need for a merger of human and machine activity. Optimal use of quality improvement tools can lead to improved patient-centered outcomes. This article outlines how quality improvement tools can be used to facilitate the patient-centered collaboration with a focus on defining evidence-practice gaps, developing actionable metrics, analyzing the impact of proposed interventions, quantifying resources, prioritizing improvement plans, evaluating results, and diffusing best practices.
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Tele-ICU improves access to high-quality critical care using a variety of information technology (IT) solutions. Recent advances in computing and telecommunications have expanded telemedicine programs nationwide. This review covers the basic principles of delivery models, technological needs, cybersecurity, health IT standards, and interoperability required for a Tele-ICU system. This will enable a better definition of Tele-ICU platforms and build robust programs.
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This review outlines various care models used in tele-intensive care unit (tele-ICU) programs. They may be differentiated by personnel and approach to care. ⋯ Others might benefit from a high-intensity model, especially those practices that desire a proactive approach to care. Also discussed is the incorporation of the education of trainees into tele-ICU models.