Abstract
BackgroundTelemedicine has been deployed to address issues in intensive care delivery, as well as to improve outcome and quality of care. Implementation of this technology has been characterized by high variability. Tele-intensive care unit (ICU) interventions involve the combination of multiple technological and organizational components, as well as interconnections of key stakeholders inside the hospital organization. The extensive literature on the benefits of tele-ICUs has been characterized as heterogeneous. On one hand, positive clinical and economical outcomes have been shown in multiple studies. On the other hand, no tangible benefits could be detected in several cases. This could be due to the diverse forms of organizations and the fact that tele-ICU interventions are complex to evaluate. The implementation context of tele-ICUs has been shown to play an important role in the success of the technology. The benefits derived from tele-ICUs depend on the organization where it is deployed and how the telemedicine systems are applied. There is therefore value in analyzing the benefits of tele-ICUs in relation to the characteristics of the organization where it is deployed. To date, research on the topic has not provided a comprehensive overview of literature taking both the technology setup and implementation context into account.ObjectiveWe present a protocol for a scoping review of the literature on telemedicine in the ICU and its benefits in intensive care. The purpose of this review is to map out evidence about telemedicine in critical care in light of the implementation context. This review could represent a valuable contribution to support the development of tele-ICU technologies and offer perspectives on possible configurations, based on the implementation context and use case.MethodsWe have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and the recommendations of the Joanna Briggs Institute methodology for scoping reviews. The scoping review and subsequent systematic review will be completed by spring 2021.ResultsThe preliminary search has been conducted. After removing all duplicates, we found 2530 results. The review can now be advanced to the next steps of the methodology, including literature database queries with appropriate keywords, retrieval of the results in a reference management tool, and screening of titles and abstracts.ConclusionsThe results of the search indicate that there is sufficient literature to complete the scoping review. Upon completion, the scoping review will provide a map of existing evidence on tele-ICU systems given the implementation context. Findings of this research could be used by researchers, clinicians, and implementation teams as they determine the appropriate setup of new or existing tele-ICU systems. The need for future research contributions and systematic reviews will be identified.International Registered Report Identifier (IRRID)DERR1-10.2196/19695
Highlights
BackgroundSince the first experiments in the late 1970s, telemedicine has increasingly been adopted in intensive care settings [1]
The scoping review will provide a map of existing evidence on tele-intensive care unit (ICU) systems given the implementation context
Findings of this research could be used by researchers, clinicians, and implementation teams as they determine the appropriate setup of new or existing tele-ICU systems
Summary
BackgroundSince the first experiments in the late 1970s, telemedicine has increasingly been adopted in intensive care settings [1]. Similar technologies have been in use in Europe An illustration of this trend is found at the Charité—Universitätsmedizin Berlin, a large university hospital in Germany, where an intensive care unit (ICU) telemedicine program focusing on quality improvement in postoperative care is being implemented [4]. Depending on the system setup, this may include audio-visual systems allowing two-way real-time communication between intensivists, bedside clinical staff, specialists, subspecialists, and patients [7] This scoping review will focus on the implementation of these conferencing and monitoring technologies. Telemedicine has been deployed to address issues in intensive care delivery, as well as to improve outcome and quality of care Implementation of this technology has been characterized by high variability. Research on the topic has not provided a comprehensive overview of literature taking both the technology setup and implementation context into account
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