Telemedicine consultation to the general ICU

Early implementations of intensive care unit (ICU) telemedicine, or tele-ICU, focused on using remote intensivists to alleviate intensivist staffing shortages and to meet national ICU staffing standards. With decreasing technology acquisition and implementation costs and improved technological capabilities, the use cases for ICU telemedicine consultations have expanded. Traditional tele-ICU consultation includes ICU patient triage for improved hospital system resource allocation and continuous monitoring of critically ill patients to promote early interventions that prevent patient deterioration. With the widespread adoption of electronic medical records, integration of medical devices, and sensorization of the environment, the boundaries of ICU tele-consulting will rapidly expand. This expansion should allow a wide array of specialist consultation for patients within an ICU while also extending the ability of intensivists to tele-consult on patients not located in the ICU. Such activities have the potential to expand the reach of ICU care beyond the walls of the ICU, leading to improved care of patients who are trending toward critical illness and thus preventing the need for ICU admission. The barriers to more universal use of telemedicine for critical care consultations include staffing needs, existing work processes, and the attitudes and perceptions of ICU staff. Models for telemedicine implementations are highly variable and depend on the resources and use cases of individual healthcare systems. At this time there is no single optimal model of ICU telemedicine. As models continue to mature and evolve, the value that telemedicine brings to critically ill patients, providers, and healthcare systems will be better established