Question

ICU Telemedicine Program: You are the chief of staff of a small hospital with a 5 bed ICU. Currently the staffing of the ICU is provided by a 2-man Internal Medicine group. You have concerns for the future as they may decide to stop coverage. Fortunately, you are part of a large hospital network. You investigate the possibility of ICU coverage at night remotely from the larger hub hospital. You must research the Resource Center for telemedicine. Now address the following question: • What advice would you give to the CEO, CIO and hospital board regarding the advantages of a VICU (i.e. Virtual ICU)? What would be the obstacles?

Answer 1

There are many advantages with VICU, some of they are: the virtual intensive care unit leverages technology to accelerate overall critical care delivery using an innovative remote and onsite model.

Intensive care unit telemedicine (tele-ICU) is technology enabled care delivered from off-site locations that was developed to address the increasing complexity of patients and insufficient supply of intensivists. Although tele-ICU deployment is increasing, it continues to cover only a small proportion of ICU patients. This is primarily due to expense, with first-year costs exceeding $50,000 per bed. Meta-analyses of outcomes indicate survival benefits and quality improvements, albeit with significant heterogeneity. Depending on the context, a wide range of estimated incremental cost-effectiveness ratios reflects variable effects on cost and outcomes, such as mortality or length of stay.

Advantages: The virtual or remote intensive care unit is a redesigned model of care that uses state-of-the-art technology to leverage the expertise and knowledge of experienced caregivers over a large group of patients in multiple intensive care units. The registered nurse working in this environment, or eRN, is an expert clinician familiar with evidence-based clinical initiatives that need to occur at the bedside to optimize outcomes for patients. The eRN assists the bedside team by providing a second layer of quality and safety. As the use of this technology continues to grow, a new dimension for critical care nursing practice is emerging that has dramatic implications for the future.

The virtual or remote intensive care unit is a redesigned model of care that uses state-of-the-art technology to leverage the expertise and knowledge of experienced caregivers over a large group of patients in multiple intensive care units.