Critical care clinics
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Critical care clinics · Jul 2019
ReviewExpansion of Telemedicine Services: Telepharmacy, Telestroke, Teledialysis, Tele-Emergency Medicine.
As more specialized care gets centralized in centers of excellence, patients admitted to rural hospitals may be at a disadvantage at the time of accessing expertise or receiving advanced care. In this setting, telemedicine models provide a justification to equalize care across different levels. ⋯ Even with all the subsets of telemedicine, including telepharmacy, telestroke, teledialysis, and tele-emergency medicine, the reasons for providing services and associated limitations are similar. However, there is a lack of empirical research including best practices and resultant outcomes for these subsets of telemedicine models.
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Critical care clinics · Jul 2019
ReviewImportant Administrative Aspects of Critical Care Telemedicine Programs.
Conceptualizing, designing, implementing, and sustaining a successful critical care telemedicine program is a complex undertaking. All of these steps must be fully accomplished as a joint effort between a host facility and the telemedicine service provider. ⋯ We briefly discuss critical aspects of establishing a sustainable business model, and aligning the critical care telemedicine program with institutional vision, goals, and mission. Discussed are important telemedicine provider infrastructure, key personnel considerations, and how a program defines and measures value.
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Intensive care unit (ICU) telemedicine lowers mortality, shortens length of stay and improves best practice compliance when implemented effectively. As a review of the literature shows, program success is not guaranteed. ⋯ The value of ICU telemedicine lies in how well the model is applied, leveraged, and integrated into the existing staff, structure, and processes at the bedside. Key domains to master to achieve this integration are discussed.
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For well over a decade, intensive care unit (ICU) telemedicine programs have been providing care to patients and families and an invaluable service to many receiving sites that are otherwise outside the traditional reach of high-quality critical care. It will be important that during this growth, outcomes regarding the unique services provided by ICU telemedicine are accurately measured, not the least of which is nursing, provider, and patient and family satisfaction. More work is required to ensure that the voices of those most intimately affected by ICU telemedicine services are heard and that programs are evaluated and adapted in response to these outcomes.