Telemedicine Care in the ICU

Hear how a typical night shift providing telemedicine care works from Dr. Jeffery Sadowsky, Tele-Critical Care physician and intensivist.

Usually around eight o’clock to midnight we’ll start our multi-disciplinary rounds for telemedicine care. We’ll beam in and find the charge nurse and ask if the she or he is available to support rounding. We start with the sickest patients first. Then, we’ll go with the bedside nurse. Or, if the patient is on a ventilator, we will work with the respiratory therapist. We review the patient care plan, including the goal for the day or the night. I make sure all of the pro re nata (PRN) are ordered, which cuts down on the calls or texts that that happen throughout the shift.

When we’re done with one patient, we move to the next and the next. When we are done with one facility, we go to the next facility. We are also available for admissions from the ED and all patient floors for rapid response. We use telemedicine care for those patients that come from the emergency room, which requires us to discuss the patient with the emergency room physician. We have secure access to the hospital’s EMR so we’ll do basic admitting orders. Then, when the patient comes up to the ICU, we will see the patient.

How Does Telemedicine Care in the ICU Work?

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Synchronous Telemedicine Coverage Models is Increasing

In the past year, we’ve seen a tremendous number of positive changes to synchronous telehealth in 3 areas:

  • Flexible Delivery Models
  • Specialty Expansion
  • Treatment Locations

To respond to the surge of patients, hospitals had to deploy a tremendous amount of flexibility. Telemedicine delivery models expanded and improved access to specialists, increased coverage and navigated rapidly changing patient volumes. TeleHospitalists provided support for onsite staff as hospitals reached capacity and clinical teams were working longer hours to care for coronavirus patients.

The greater demand for healthcare also opened minds about how telemedicine can improve access to specialties where providers are not usually available. Suddenly, hospitals in rural communities unable to transfer ICU patients and needed direct, immediate support from infectious disease (ID), critical care and pulmonology physicians. While Eagle has been providing ICU telemedicine and remote ID coverage for some time, few other telemedicine providers offered these specialties. The unique situation will hopefully expand care for the long term.

Finally, necessity is the mother of invention. After adopting more telemedicine, hospitals and clinicians suddenly saw new places where telemedicine could improve the speed and quality of care.

Synchronous Telemedicine Care

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