We have authored numerous blog posts over the years discussing telemedicine or virtual medical visits. With the COVID pandemic dominating our lives, telemedicine has achieved a new recognition. In particular, we are learning that ICU telemedicine saves lives.
But even before the pandemic, ICU telemedicine was achieving significant results. The reason was simple: many smaller hospitals were unable to have full-time intensivists ready at the ICU bedside. To fill that gap, hospitals were electronically communicating with remote intensivists who had access to monitors, medical records, and test results. In some cases, there was audio-visual, two-way communication to allow the remote intensivist to interact with bedside nurses in real time.
Stationed at a remote “command center,” an intensivist could monitor patients in several hospitals, sometimes in several different states. In some cases, there was dedicated software designed to identify patients who are in need of additional care. Some critics argued out that direct communication and hands-on evaluation with patients are a crucial part of medical care. But in most cases, information about the patient’s condition is coming from electronic monitoring of body systems.
The ICU telemedicine route was a necessity, according to many observers. In most cases, 24/7 intensive care was rare outside of large hospitals and academic centers, and the practice of having intensivists on site only at certain times of the day left gaps in care that could be life-threatening. One recent survey found that almost half of all U.S. hospitals had no intensivist at all or had only one for the entire hospital.
A case we recently handled showed the flaws of “part-time” intensivists. Our client received the wrong medication given by a nurse during the night shift, and he rapidly deteriorated. When the daytime intensivist came on duty at 7:00 a.m., it was just in time to reverse the medication. Our client lived, but was left totally blind because of lack of oxygen to his optic nerves. A telemedicine intensivist could have avoided this tragedy.
A study done within the Cleveland Clinic Health System showed that, of 600,000 patients treated in the Cleveland Clinic hospitals between 2010 to 2019, when ICU telemedicine was utilized, mortality was reduced and patients spent less time in the ICU’s. A study author said: “We think these findings provide further reassurance about the value of ICU telemedicine, particular in light of our collective experience in 2020.”
