How to develop a tele-ICU model?

The concept of the tele-ICU (intensive care unit) is about 30 years old and more hospitals are utilizing it to cover multiple hospitals in their system or for hospitals that lack on-site critical care coverage such as in the rural setting. Doing a needs analysis, picking the appropriate committee to oversee development of the correct model, choosing quality metrics to measure, and designing an implementation plan that has a timeline is how the process should begin. Research including visitation to established programs and connecting with professional societies are helpful. Developing both a business and financial plan will optimize the value of a tele-ICU program. The innovative ICU nursing director will help to integrate a telemedicine program seamlessly with the on-site program to insure a successful program that benefits patients, their families, the ICU staff, and the hospital.

A working lexicon for the tele-intensive care unit: we need to define tele-intensive care unit to grow and understand it.

Telemedicine in the intensive care unit (Tele-ICU) has grown exponentially since the first formalized program in 2000. Initially, there was limited product choice, and certain capabilities have been engineered into the process with the implication of necessity. New technology is evolving, and new vendors are entering the market place, which should yield a multitude of technologies from which to select. To date, there has been no organized lexicon designed to facilitate communication, comparison, or evaluation. This article is designed as a starting point to develop a lexicon applicable to all technologies for the Tele-ICU with the goal of facilitating clinical comparisons and administrative choices.

Practice challenges of intensive care unit telemedicine.

For more than 20 years, a 100-year-old state-based system for medical licensure has not progressed commensurate with the level of 21st century technology development. Despite government and nongovernment organizational attempts, each state maintains a process of variable and time-consuming requirements with lack of reciprocity. Lack of available reimbursement for Tele-ICU physician services is thought to be a long-standing and significant barrier to the rapid adoption of Tele-ICU programs. By reviewing the reimbursement guidelines for telehealth services across all major patient financial classes, a model is discussed for developing financial projections to determine exactly what reimbursement is available for Tele-ICU programs.