Abstract
BackgroundThe role of telemedicine in intensive care has been increasing steadily. Tele–intensive care unit (ICU) interventions are varied and can be used in different levels of treatment, often with direct implications for the intensive care processes. Although a substantial body of primary and secondary literature has been published on the topic, there is a need for broadening the understanding of the organizational factors influencing the effectiveness of telemedical interventions in the ICU.ObjectiveThis scoping review aims to provide a map of existing evidence on tele-ICU interventions, focusing on the analysis of the implementation context and identifying areas for further technological research.MethodsA research protocol outlining the method has been published in JMIR Research Protocols. This review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A core research team was assembled to provide feedback and discuss findings.ResultsA total of 3019 results were retrieved. After screening, 25 studies were included in the final analysis. We were able to characterize the context of tele-ICU studies and identify three use cases for tele-ICU interventions. The first use case is extending coverage, which describes interventions aimed at extending the availability of intensive care capabilities. The second use case is improving compliance, which includes interventions targeted at improving patient safety, intensive care best practices, and quality of care. The third use case, facilitating transfer, describes telemedicine interventions targeted toward the management of patient transfers to or from the ICU.ConclusionsThe benefits of tele-ICU interventions have been well documented for centralized systems aimed at extending critical care capabilities in a community setting and improving care compliance in tertiary hospitals. No strong evidence has been found on the reduction of patient transfers following tele-ICU intervention.International Registered Report Identifier (IRRID)RR2-10.2196/19695
Highlights
Telemedicine has been increasingly used in intensive care, and approximately 15% of intensive care beds in the United States currently partake in telemedical programs [1,2,3]
A research protocol for this review was published in JMIR Research Protocols in December 2020 [11], which was developed in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and best practices advanced by Arksey and O’Malley [18] and the Joanna Briggs Institute [19]
Tele-intensive care unit (ICU) systems have been deployed in numerous implementation contexts, which we characterized in three main https://www.jmir.org/2021/11/e32264
Summary
Telemedicine has been increasingly used in intensive care, and approximately 15% of intensive care beds in the United States currently partake in telemedical programs [1,2,3]. Tele-ICU interventions are varied, can be offered in different levels of intensive care service, and can be customized to meet the specific intensive care needs of hospitals [3,5,6,7]. Objective: This scoping review aims to provide a map of existing evidence on tele-ICU interventions, focusing on the analysis of the implementation context and identifying areas for further technological research. The first use case is extending coverage, which describes interventions aimed at extending the availability of intensive care capabilities. The second use case is improving compliance, which includes interventions targeted at improving patient safety, intensive care best practices, and quality of care. Conclusions: The benefits of tele-ICU interventions have been well documented for centralized systems aimed at extending critical care capabilities in a community setting and improving care compliance in tertiary hospitals.
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