SCCM Resource Library-Looking Back and Defining the Future of Telecritical Care

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Telecritical care (TCC) is a pivotal development aimed at bridging the resource and personnel gaps in intensive care units (ICUs), particularly in rural and critical access hospitals. Initiated on an ad hoc basis, TCC's framework and models have evolved to enable remote healthcare teams to provide critical care assistance. By the end of the 2010s, interoperability between electronic medical records and TCC systems emerged, offering opportunities to mitigate staffing shortages, reduce clinician burnout, and enhance patient care.<br /><br />Initially guided by the American Association of Critical-Care Nurses (AACN) in 2013, TCC was associated with reduced mortality and improved patient safety. Despite these benefits, adoption was slow, with only 17.9% of US hospitals incorporating TCC by 2018. However, the COVID-19 pandemic significantly accelerated TCC adoption, helping manage healthcare demands due to relaxed legal and billing restrictions and increased reliance on telemedicine. This situation highlighted disparities in healthcare resources and capabilities, prompting initiatives like the National Emergency Tele Critical Care Network (NETCCN) to enhance emergency acute care services.<br /><br />Technology and innovation have been pivotal, with prediction models and clinical decision support (CDS) systems introduced to improve patient monitoring and resource allocation. The pandemic fostered the development of standardized TCC models adaptable to different circumstances, marking a vital response to evolving healthcare challenges.<br /><br />Surveys indicate that cost, perceived need, and workflow challenges are barriers, while CDS use is seen as beneficial but needing enhancement. TCC adoption varies across health systems, with collaborative networks now essential in defining best practices.<br /><br />As TCC grows, developing cost-effective models with maximum value is imperative, directing future research to harness its full potential to improve care access, safety, and workforce efficiency worldwide. The SCCM and Critical Care Collaborative Societies are working to formulate consensus-based strategies for ongoing TCC development and research priorities.

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Professional Development and Education, 2023, 0:06:30

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"This article was first published in the Summer 2023 issue of Critical Connections.

Of all healthcare systems, intensive care units have the highest mortality, cost, and need for multiprofessional teams; however, there are significant gaps between availability and the demand for staff and resources. Telecritical care (TCC) was introduced to bridge this gap and was initially used on an ad hoc basis. Over time, models of care have emerged to establish a framework for the type and scope of care provided by remote teams. The rapid growth of TCC has now outpaced evidence-based research defining terminology, value, processes, and outcomes, making it imperative to look back and review existing research.

Critical Connections, the critical care industry’s only newsmagazine, provides information on cutting-edge topics in critical care useful to the entire multiprofessional team."

Meta Tag

Content Type Article

Knowledge Area Professional Development and Education

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag Telemedicine eICU

Tag Innovation

Year 2023

Keywords

Telecritical care

intensive care units

remote healthcare

electronic medical records

COVID-19 pandemic

National Emergency Tele Critical Care Network

clinical decision support

healthcare disparities

workflow challenges

cost-effective models

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