TeleICU, also known as eICU, is the diagnosis and treatment of the most critical hospital patients by a remote intensivist using technology like videoconferencing. It makes it possible for hospitals to have access to critical care specialists in the ICU, Emergency Room or Med/Surg floors and be connected face-to-face in minutes.
Intensivists specialize in unstable and critical patients with unpredictable medical prognoses interacting with virtually every facet of a hospital. Similar to emergency department physicians and hospitalists, intensivists are an integral component of acute care telemedicine.
TeleICU is very much like a typical ICU workflow―the difference is that the critical care physician is remote. Like other hospital ICU physicians, teleIntensivists begin each shift by rounding with the patient care team and discussing each patient, classifying them by acuity:
1. Patients with acute needs that have potential issues and challenges
2. Patients that can be downgraded or transferred out of the ICU
3. Patients in the “grey area” where the trajectory of the illness is less clear
Those patients identified with potential problems or increased acuity due to their diagnoses and progressing illness can be escalated for a full in-depth evaluation by the teleIntensivist and on-site care teams. The goal is to proactively assess and treat patients before decompensation occurs.
When an emergency occurs in the ICU, the patient care team can request a consult (similar to paging a doctor who may be elsewhere in the hospital.) TeleIntensivists can run codes, talk the care team through procedures, as well as speak directly to patients and/or their families to help with difficult care decisions.
For many organizations, finding nighttime coverage is a challenge. Some teleIntensivists specialize as nocturnalists, and support the on-site clinical team and cover the ICU overnight.
There are several reasons that the use of teleICU is growing:
standards.
There are multiple use cases in hospitals for teleICU.
Remote ICU monitoring, also known as eICU, utilizes technology to monitor patient status and exchange that information in real-time to an off-site command center (or bunker) with a critical care team. ICU beds are wired so that patient information can be relayed, and alarms triggered for the onsite staff. Some remote ICU monitoring companies offer rounding by intensivists or critical care nurses, while others are only supplemental oversight. Remote ICU monitoring is more expensive than teleICU as defined above.
TeleICU is a cost-effective way to connect intensivists with the hospitals who need them to treat their most critical patients. With the shortage of intensivists nationwide, teleICU allows hospitals to provide access to these highly-trained specialists to their most critically-ill patients. Learn more about teleICU with the resources below.
Vision screenings are not comprehensive eye exams. Screenings usually take only a few minutes and are often performed by volunteers who are not eye care professionals.
In many cases, vision screenings are nothing more than a visual acuity test where you’re asked to identify the smallest letters you can on a vision chart across the room.
Vision screenings typically are designed to only detect subnormal visual acuity and major vision problems — as quickly and cost-effectively as possible. They generally are ineffective for detecting more subtle vision problems and potentially sight-robbing eye diseases.
People who fail a vision screening (usually because their visual acuity is worse than 20/40) are made aware of this and are encouraged to visit an eye doctor so they can have their vision problem professionally diagnosed and treated with eyeglasses, contact lenses, medicine or surgery.
Good vision is essential for children to reach their full academic potential. It’s been widely stated that roughly 80 percent of what children learn in school is presented visually, and vision problems can have a profound effect on learning.
According to the American Optometric Association, an estimated 20 percent of preschool children have vision problems. Other research shows that 24 percent of adolescents with correctable refractive errors (nearsightedness, farsightedness and/or astigmatism) don’t have their vision fully corrected with up-to-date prescription eyeglasses or contact lenses.
Even if your child passes a school vision screening, it doesn’t guarantee he or she has perfect vision or has all the required visual skills needed for optimum performance in the classroom.
In fact, a number of studies have identified significant challenges and shortcomings of children’s vision screenings, including:
On the other end of the age spectrum, many older Americans often forgo routine eye exams and falsely believe that free vision screenings offer adequate monitoring and protection of their eyesight.
This is extremely dangerous, since the most common causes of blindness — glaucoma, diabetic retinopathy and macular degeneration — increase with age. Vision loss often can be prevented or reduced if these conditions are diagnosed and treated early. But the only way this can be done is to have routine comprehensive eye exams.
Don’t take chances with your eyesight as you get older. It may be sufficient to have a comprehensive eye exam every two years in your early adult life. But if you’re over age 60, have an annual eye exam to preserve your vision and make sure you are seeing the world as clearly as possible.