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:

• Physician shortages make it hard to recruit enough intensivists to staff appropriately.
• An aging population means that there is more demand for services.
• The COVID-19 pandemic has highlighted the need to protect providers so that they
  can avoid exposure and continue to treat patients
• With high demand, and not enough supply, physicians experience burnout trying to
  make up the gap.
• Rapid acceleration of the adoption of technology, like mobile phones, means
  consumers expect more convenience in their healthcare.
  Even if a hospital has intensivists on staff, supplemental teleICU coverage can offload some
  of their work, allowing them to gain visibility into what is happening across the hospital and
  leverage their own skillset more broadly.

• Access to board-certified US trained intensivists to assist with clinically complex
  patients anywhere in hospital​
• Earlier interventions for critically ill patients​
• Increased awareness of high acuity patients for proactive monitoring​
• Improved care quality and compliance with core metrics​
• Protocol-driven best practices of care ​
• Support for ED staff with difficult admit vs transfer decisions​
• More timely discharges from the ICU unit​
• Decreased ventilator days​
• Can help hospitals achieve and maintain The Leapfrog Group’s quality and safety

standards.

There are multiple use cases in hospitals for teleICU.

• In the emergency room, remote specialists can “beam in” to consult with the emergency department onsite staff to determine whether the patient should be moved to the ICU.
• In the ICU, a teleIntensivist can provide expertise to onsite staff regarding care plans for critically-ill patients.
• Telemedicine can be used with admitted patients who become more critically-ill, as well with those who have complications from surgery.

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.